2018-19 Annual Business Plan 2 Table of Contents Transmittal Letter from the Champlain LHIN Board Chair ..................................................................... 4 Mandate and Strategic Directions ............................................................................................................. 6 Strategic Foundation ............................................................................................................................. 7 Strategic Directions .............................................................................................................................. 7 Our Strategic Plan at a Glance ............................................................................................................. 8 Alignment with the Priorities of Minister’s Mandate Letter .................................................................... 9 Overview: Current and Planned Programs / Activities........................................................................... 12 Our Region is Large and Diverse ....................................................................................................... 16 Most People are Healthy…But not All ................................................................................................ 17 Health System Oversight and Management Priorities ............................................................................ 20 Integration: Improve the Patient and Family Experience Across the Continuum of Care ................. 21 Access: Ensure Health Services are Timely and Equitable ................................................................ 27 Sustainability: Increase the Value of our Health System for the People it Serves ............................. 33 LHIN-Delivered Home and Community Priorities ................................................................................ 37 Indigenous Peoples ................................................................................................................................. 40 French Language Services ...................................................................................................................... 42 Performance Measures ............................................................................................................................ 43 Risks and Mitigation Plans ..................................................................................................................... 45 LHIN Operations Spending Plan ............................................................................................................ 48 LHIN Staffing Plan ................................................................................................................................. 50 Communications & Community Engagement ........................................................................................ 52 3 Transmittal Letter from the Champlain LHIN Board Chair March 1, 2018 Tim Hadwen Assistant Deputy Minister Health System Accountability, Performance and French Language Services Division Ministry of Health and Long-Term Care 80 Grosvenor Street, 5th Floor, Hepburn Block Toronto, Ontario M7A 1R3 Dear Mr. Hadwen: Please find attached the Champlain LHIN’s Annual Business Plan 2018-19, which has been endorsed by the Board of Directors. The plan outlines the goals, objectives and actions for the fiscal year as we work towards our vision of “Healthy people and healthy communities supported by a quality, accessible health system”. The plan builds on previous years’ successes and supports the Ministry of Health and Long-Term Care provincial priorities. Patients First created the foundation of an integrated health care system to deliver world-class patient care closer to home, with services distributed equitably across the province. As we work with the Ministry, LHINs and local health system partners to collectively transform health care, local care planning and delivery will happen at the community level and will focus on the patient and their family as the key partners in delivering care. By putting patients first in everything we do, we will provide faster access to the care patients need today and make the necessary investments to ensure our health system will be there for patients of generations to come. As described in the Integrated Health Service Plan 2016-19, the Champlain LHIN adopted three strategic directions aligned with the provincial report Patients First: Action Plan for Health Care, to guide an ambitious agenda for transforming our health system. Our three strategic directions are: 1) Integration: Improve the patient and family experience across the continuum of care 2) Access: Ensure health services are timely and equitable 3) Sustainability: Increase the value of our health system for the people it serves The Annual Business Plan 2018-19 seeks to respond to local issues while contributing to the fulfillment of the Ministry’s promise of a caring, integrated experience for patients, and faster access to quality health services for all Ontarians at every stage of life. 4 This year, we will move boldly on the mobilization of sub-regions in Champlain. As we shift health system planning to the sub-regional level, we will focus on the social determinants of health and empower sub-regions to take control of the health of their respective populations. Through strategic partnerships, both within the health sector and beyond, we will develop new and innovative models of care. With our partners, we will reshape the delivery of mental health services, modernize the provision of home and community care and reimagine long-term care. All of this, will be supported by the meaningful engagement and empowerment of the patients, caregivers and communities we serve. The Champlain LHIN has worked actively with the Indigenous Health Circle Forum (Circle) since 2008. This year, we will further strengthen our commitment and that of our health service providers to the health and wellness of Indigenous Peoples through our partnership with the Circle. In addition, the LHIN will respond to the Calls to Action of the Truth and Reconciliation Commission of Canada to address the priorities it identified as important to the health and well-being of Indigenous communities. As well, our efforts to achieve a more integrated, comprehensive and equitable health care system will continue to consider the diverse needs of our region, including French language and multicultural service delivery. Our business plan is ambitious, but its achievement is integral to meeting the expectations laid-out in the Integrated Health Service Plan 2016-19, advancing the priorities described in the Minister’s mandate letter, and living up to our Ministry-LHIN Accountability Agreement commitments. Sincerely, Jean-Pierre Boisclair Board Chair 5 Mandate and Strategic Our work is focused on improving the health care system for residents who live in Directions communities within our geographic boundaries. In May 2017-18, the Ministry of Health and Long-Term Care (Ministry) expanded the Under the Local Health System Integration Act, Champlain LHIN’s mandate to include the 2006, the mandate of the Champlain Local governance and management of home and Health Integration Network (LHIN) is to community care in the region. engage the community and promote the integration of the local health system. The Ministry also set out clear expectations for the Champlain LHIN for 2018-19. This year, in It is our role to plan for health service needs in support of the Patients First: Action Plan for the region, including needs regarding physician Health Care, we will work together with the resources. We fund health service providers Ministry on a set of shared priorities. (Providers) within several health sectors and ensure they are accountable for achieving We will continue to harness the opportunities performance standards. We are accountable to provided through Patients First to broaden our the Minister for the performance of the local impact on the health of those we serve. health system and its health services. Our fourth strategic plan, Integrated Health The Champlain LHIN also delivers home and Service Plan (IHSP) 2016-19, reflects the needs community care service and resources to and aspirations of our community. Developed support over 58,000 patients each year at home, through extensive consultation with the local or in the community. community (including Providers and their boards, health service consumers, the public We recognize the impact of the social and other partners), the IHSP outlines the determinants of health and work towards the LHIN’s priorities to achieve its vision and meet reduction or elimination of health disparities its mandate of integrating the health care and inequities. We work with primary care, system at the local level. public health and community services to develop and implement health promotion strategies. Ministry–LHIN Shared Priorities  Improve the patient experience by partnering with patients in health care planning and by delivering care that reflects the patient voice and is responsive to patients' needs, values and preferences.  Address the root causes of health inequities and the social determinants of health.  Reduce the burden of disease and chronic illness and investing in health promotion.  Create healthy communities by improving access to primary care and reducing wait times for specialist care, mental health & addictions services, home and community care and acute care for patients when they need it, which will reduce variation in access across the province.  Break down silos between our health care sectors and providers to ensure seamless transitions for patients, and to ensure that providers work together and in collaboration with patients to deliver the best possible care.  Support innovation by delivering new models of care and digital solutions to make accessing care easier for patients and more efficient for health care providers. 6 The IHSP is a strategic plan that describes how Our strategic directions reflect the needs of the the LHIN’s priorities align with those of the region and were developed to support the key Ministry. objectives of the Ministry, described in Patients First: Action Plan for Health Care1. The Annual Business Plan (ABP) is the yearly plan that maps out how we are fulfilling the Our IHSP addresses four population health IHSP’s strategic goals. It forms part of the outcomes: Ministry-LHIN Accountability Agreement, and 1) Being Healthy – Helping individuals stay is driven by the Champlain LHIN’s vision, physically and mentally healthy and prevent mission, and values. risk of injury, illness, chronic condition or disability As 2018-19 will be the final year of our three- year strategic plan, this year will provide an 2) Getting Better – Helping individuals return opportunity to re-examine our mission, vision to health after suffering an acute illness or and values and engage stakeholders in the injury development of our next strategic plan. 3) Living with Illness or Disability – Helping individuals receive appropriate care and Strategic Foundation support related to chronic illness or disability 4) Having Choices at End-of-life – Helping individuals receive care and support that relieves suffering and improves the quality of living with, or dying from, a progressive, life-limiting illness. Strategic Directions The IHSP 2016-19 identifies three strategic directions that will guide our work during the three-year period. The actions we take in one may support actions taken in another: 1) Integration: Improve the patient and family experience across the continuum of care 2) Access: Ensure health services are timely and equitable 3) Sustainability: Increase the value of our health system for the people it serves. 1 Ministry of Health and Long-Term Care (2015). Patients First: Action Plan for Health Care. Toronto, ON. 7 This ABP will describe how we will operationalize the second year of our strategic plan. Our Strategic Plan at a Glance 8 Alignment with the Priorities of Minister’s Mandate Letter Minister’s Mandate Letter Key commitments, goals, actions and/or outcomes from the LHIN’s ABP Priorities Transparency  Work with our provincial partners to complete a review of Ontario LHINs and identify opportunities and Public for savings that can be reinvested into patient care. Accountability  Strive to attain a high degree of transparency, through regular performance reports to the Ministry of Health and Long-Term Care, our Board of Directors and the public.  Identify measures and performance targets, where applicable, that align with our Accountability Agreement with the Ministry, our Integrated Health Service Plan and other provincial and local priorities.  Effectively manage all strategic and operational risks while ensuring alignment with government priorities and achievement of our Annual Business Plan. Improve the  Continue to advance our strategic direction to improve the patient and family experience across Patient the continuum of care. Experience  Continue to engage our Patient and Family Advisory Committee to ensure patients and families have a meaningful voice in local health system planning.  Improve coordination of care for people with complex health conditions through the Health Links approach.  Work towards improving transitions for patients between different health sectors and providers so that patients receive seamless, coordinated care and only need to tell their story once.  Enhance respite care for caregivers of people with dementia. Build Healthy  Continue development of integrated networks of care in all LHIN sub-regions that are informed by Communities community engagement and guided by a common understanding of the unique population health Informed by needs within each sub-region. Population  Expand our sub-regional planning efforts to focus on strengthening, coordinating and integrating Health Planning primary care, and home and community care. Through sub-regional planning, we will collaborate with health system partners to address health gaps and improve patient experience and outcomes.  Partner with Public Health in the collection and analysis of information concerning social determinants of health, the development of targeted population health assessments (including mental health and addictions) and aligning, where appropriate, our planning and community engagement efforts to inform future strategic plans. Quality  Work with local health system partners to introduce new Quality Based Procedures. Improvement,  Improve the measurement and quality of the client / caregiver experience for individuals receiving Consistency and home care services. Outcomes-  Recruit clinical leads in each of five sub-regions to engage local clinicians. Based Delivery  Monitor our progress against performance measures and targets that align with quality and patient care standards. Equity  Collaborate with Public Health to conduct population health planning within LHIN sub-regions supported through the collection and analysis of information concerning social determinants of 9 Minister’s Mandate Letter Key commitments, goals, actions and/or outcomes from the LHIN’s ABP Priorities health.  Work together with Public Health to address the health priorities of distinct populations, such as Indigenous, Francophone and immigrant communities.  Address the region’s diversity by reaching out to Francophone, Indigenous and immigrant communities through communications.  Finalize an equity framework for Indigenous Peoples.  Ensure the Champlain LHIN provides the active offer of French language services to Francophones and identify areas of the health system that require more services in French.  Develop plans to improve system navigation, cultural competency, and pathways to care for trans, two-spirit, intersex and gender diverse communities. Primary Care  Recruit clinical leads in each of five sub-regions to engage local clinicians.  Engage our regional Primary Care Council in system-level planning.  Test a facilitated-outreach approach that connects small primary care practices and their patients to care teams.  Develop a plan with input from primary care providers, patients, family caregivers and partners that links care coordinators and system navigators to primary care.  Improving access to inter-professional health care providers to ensure comprehensive care.  Work with providers to align health link areas with sub-regions and continue to support the expansion of the health link approach to reach 10,000 people across the region. Hospitals and  Seek opportunities to bundle payments for certain types of care and develop reinvestment Partners strategies to direct resources to critical priorities.  Support hospital improvement processes to reduce time spent in the emergency room.  Reduce hospital readmissions by enhancing allied care supports for the management of vascular health conditions focused on rural communities across Champlain.  As part of our performance measurement framework, monitor the percentage of alternate level of care (ALC) days and emergency department lengths of stay. Specialist Care  Work with providers to reduce wait times and coordinate access to services for musculoskeletal conditions and advance the implementation of related funding models.  Work with providers to implement mental health screening tools for anxiety and depression.  Increase utilization of eConsult services to further improve access and care and minimize the number of unnecessary referrals. Home and  Continue to implement initiatives that strengthen home and community care. Community Care  Increase the stability and engagement of the home and community care workforce.  Integrate and enhance community support services including homemaking, attendant outreach and day services to improve access and reduce wait times.  Work with the Ontario Palliative Care Network, Champlain Hospice Palliative Care Program, the Champlain Regional Cancer Program, and other health system partners, to address inequities in the availability of services and programs for people at end-of-life. Long-Term Care  Enhance access to alternatives to long-term care homes.  Support the Ministry’s multi-year Aging with Confidence strategy. 10