Meeting Materials - Central West LHIN

Transcription

BOARD OF DIRECTORS' MEETING - WED., JUNE 22, 2016 - CALL TO ORDER
BOARD OF DIRECTORS’ MEETING
Regular Agenda
WEDNESDAY, JUNE 22, 2016
Commencing at 5:00 p.m. at the Central West LHIN Office
8 Nelson Street West, Suite 300, Brampton, Ontario
Board Members:
John McDermid (Acting Chair), Ken Topping (Member) Lorraine Gandolfo (Member),
Suzan Hall (Member), Pardeep Singh Nagra (Member), Adrian Bita (Member), Jeff Payne (Member)
LHIN Staff:
Scott McLeod (CEO), Brock Hovey, Mark Edmonds, Tom Miller, Michele Williams, Elizabeth Salvaterra
Regrets:
Maria Britto (Board Chair)
#
1.0
Agenda Item
Call to Order
1.1 Approval of Agenda
(Attachment)
1.2 Conflict of Interest
2.0
Consent Agenda
(Attachment)
3.0
3.1 Report from the
Board Chair
To be Accomplished
The Chair to welcome Guests and any
Observers from the public and clarify the
meeting format.
To review and approve the Agenda for the
Meeting.
To remind members of the Conflict of Interest
Policy and procedures for declaring a potential
conflict.
To review and approve the Consent Agenda and
remove items to the Regular Agenda for further
discussion, as required.
Board Members to receive a verbal update from
the Board Chair and opportunity for Board
Members to ask questions and seek clarification.
Lead
John McDermid
5:00 – 5:05 p.m.
Board Members
5:05 – 5:15 p.m.
John McDermid
5:15 – 5:35 p.m.
3.2 Report from the Chief
Executive Officer
(Attachment)
Board Members to receive a brief overview of
Scott McLeod
the CEO’s written monthly report and an
opportunity to highlight specific activities, as well
as an opportunity for Board Members to ask
questions and seek clarification.
4.0 Board Education / Generative Dialogue
4.1 Patients’ First Legislation
Board Members to discuss the introduction of the Scott McLeod
(Attachment)
Patients’ First Legislation
5.0 Strategic Dialogue
5.1 2015-2016 Balanced
Scorecard Spring/Year-End Cycle
- (Attachment)
5.2 2016/17 – 1st Quarter (Q1)
Enterprise Risk Management
(ERM) Report - (Attachment)
Time
Board Members to receive an overview of the
Brock Hovey/
2015-2016 Central West LHIN Balanced
Elizabeth Salvaterra
Scorecard Spring/Year-End Cycle
Board Members to review and approve the 2016- Brock Hovey
2017 – 1st Quarter (Q1) Enterprise Risk
Management (ERM) Report
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5:35 – 6:05 p.m.
6:05 – 6:25 p.m.
6:25 – 6:40 p.m.
#
Agenda Item
To be Accomplished
5.3 2015-2016 Annual Report
(Attachment)
6.0
Lead
Time
Board Members to review and approve changes
incorporated into the 2015-2016 Annual Report
since the last Board Meeting
Mark Edmonds/
Tom Miller
6:40 – 6:50 p.m.
Board Members to receive a verbal update on
discussions held at the Quality Committee
meeting of Monday, June 13, 2016 and the
Board to approve any recommendations coming
forward from that meeting
John McDermid
6:50 – 7:00 p.m.
6.2 Verbal Report from
Governance Committee Meeting – discussions held at the Governance Committee
Thursday, June 9, 2016
meeting of Thursday, June 9, 2016 and the
Board to approve any recommendations coming
forward from that meeting
Lorraine Gandolfo
7:00 – 7:10 p.m.
6.3 Verbal Report from Finance
& Audit Committee Meeting) –
Monday, June 20, 2016
(Attachment
Adrian Bita
7:10 – 7:20 p.m.
Fiduciary Dialogue
6.1 Verbal Report of the Quality
Committee Meeting – Monday,
June 13, 2016
discussions held at the Finance & Audit
Committee meeting of Monday, June 20, 2016
and the Board to approve any recommendations
coming forward from that meeting
ß
2016/2017 - 1st Quarter (Q1) Report
6.4 Quarterly CEO Attestation
(Attachment)
Board Members to approve the 2016-2017 - 1st
Quarter (Q1) CEO Attestation (for the period
March 1, 2016 to June 30, 2016)
Scott McLeod
7:20 – 7:30 p.m.
7.0
In-Camera Session
As required
John McDermid
7:30 p.m.
8.0
Adjournment of Meeting
To summarize action items and adjourn meeting
John McDermid
8:00 p.m.
ITEMS ATTACHED TO AGENDA – FOR INFORMATION ONLY:
1. Osler/Headwaters/CCAC Regional Service Model
2. Region of Peel – Community Water Fluoridation Committee – Reports and Presentation, June 9, 2016 (3 Attachments)
Date of Next Board of Directors’ Meeting:
WEDNESDAY, SEPTEMBER 28, 2016
Central West LHIN Office, 8 Nelson Street West, Suite 300
Brampton, Ontario
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MEMORANDUM
To:
All Osler Staff, Physicians, and Volunteers
From:
Cathy Hecimovich, CEO
Liz Ruegg, President and CEO
Matthew Anderson, President and CEO
Date:
Monday, June 13, 2016
Subject: Regional Service Model
Over the past two years, the back office partnership has enabled new and innovative ways to deliver
care across our three organizations to benefit the more than 1.3 million people we serve in Central West
region. This unique partnership supports our shared vision to put patients at the center of all we do by
strategically aligning administrative functions and reinvesting savings into patient care.
In support of our shared commitment to improve access to care and create a long-term sustainable
model, we have evolved the Joint Back Office to a new regional Service Model and increased our
regional vice president complement from five to six.
Our new regional non-clinical executive team now includes two dedicated VP, Corporate Services roles
responsible for operations excellence at Headwaters Health Care Centre and the Central West CCAC
respectively and four Joint VPs. The VPs Corporate Services will work in partnership with the Joint VPs to
ensure delivery of non-clinical support services across the region.
Today, we are pleased to announce our new non-clinical support services VPs complement.
Bob Varga has accepted the role of VP, Corporate Services at CW CCAC. Bob will report directly to Cathy
Hecimovich and have onsite responsibility for Human Resources/Organizational Development (HR/OD),
Finance, Facilities, IM/IT, Patient Experience, Communications/Strategy, Privacy, Contracts and Service
Provider Relations. Bob will be located onsite at the CCAC.
Monique Porlier has accepted the role of interim VP, Corporate Services at Headwaters. Monique will
start on June 14, 2016 and have onsite responsibility for HR/OD, Finance, Facilities, IM/IT and
Biomedical Engineering, Patient Experience, Communications/Strategy, Maintenance/Facilities, Food
Services, Materials Management and Security. Monique joins us from the Canadian Cancer Society and
prior to that, Halton Healthcare Services, where she was a senior operations and finance executive at
both. Monique will be located onsite at Headwaters.
To accommodate these onsite positions, we have restructured the existing JVP portfolios to shift from
five regional positions to four. This new model supports our partnership, continues the work of our
regional teams and aligns with the Ministry of Health and Long-Term Care’s vision of health care
transformation in Ontario.
Service Model Communications
All Staff Memo
FINAL June 13, 2016
4
Joint VPs include:
Susan deRyk, JVP, Service Quality and Community Relations - with new responsibilities for Patient
Registration, Locating/Switchboard and Library Services in addition to Patient Experience,
Communications, Strategy, and (Osler’s) Print Shop/Mailroom. This portfolio is well-positioned to
promote a positive patient experience by bundling patient and community-facing support service areas.
Ann Ford, JVP, Information Technology and Redevelopment - with new responsibilities for IT in
addition to Redevelopment, Facilities, Security and Parking. This portfolio promotes innovation in
technology, infrastructure and facilities development across the region.
Florine Lobo, Joint Chief Financial Officer & JVP, Organizational Performance - with new
responsibilities for Information Management: Decision Support, Health Records & Business Intelligence
in addition to Financial Services. This portfolio promotes innovative solutions and strategic financial
advice to support service delivery.
Christine Nuernberger, JVP, Human Resources & Organizational Development - with new
responsibilities for the Project Management Office (PMO) in addition to HR and OD. This portfolio will
focus on promoting a culture of excellence across the region, supporting our Evidence Based Leadership
(EBL), change management and project leadership.
As a result of the realignment to the Service Model, there are several responsibility and reporting shifts
for a number of Executive Directors, Directors and Managers across all three organizations. Everyone
directly affected has been personally notified. A copy of the organization charts will be available within
the next day on the intranet.
We look forward to continuing to find additional ways to partner to enhance patient care and increase
access to health care services close to home within the Central West region.
Thank you for your support as we continue to work together to benefit the patients, families and
communities we collectively serve.
Service Model Communications
All Staff Memo
FINAL June 13, 2016
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BOARD OF DIRECTORS' MEETING - WED., JUNE 22, 2016 - CONSENT AGENDA
BOARD OF DIRECTORS’ MEETING
2.0 Consent Agenda
WEDNESDAY, JUNE 22, 2016
8 Nelson Street West, Suite 300
Brampton, Ontario
________________________________________________________________________________________
Attachments:
2.1
Minutes of Board of Directors’ Meeting held Wednesday, May 25, 2016
2.2
Minutes of Finance & Audit Committee Meeting held Tuesday, May 24, 2016
2.3
Minutes of Governance Committee Meeting held Thursday, April 14, 2016
2.4
Minutes of Quality Committee Meeting held Monday, April 11, 2016
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MINUTES OF THE BOARD OF DIRECTORS’ MEETING
WEDNESDAY, MAY 25, 2016
Commencing at 2:00 p.m.
55 John Street (Village of Alton)
Caledon, Ontario
Board Members Present:
LHIN Staff Present:
Maria Britto (Board Chair), John McDermid (Vice Chair), Lorraine Gandolfo (Member),
Suzan Hall (Member), Pardeep Singh Nagra (Member), Adrian Bita (Member),
Jeff Payne (Member)
Scott McLeod (CEO), Brock Hovey, Mark Edmonds, Michele Williams, Tom Miller
Regrets:
Gerry Merkley (Member)
1.0
Call to Order
Maria Britto, Board Chair, called the Board Meeting to order at 2:00 p.m. and noted regrets for Gerry Merkley,
Board Member. There were no Observers in attendance.
1.1
Approval of Agenda
MOVED by Suzan Hall and SECONDED by Adrian Bita, that the Regular Agenda for the Central
West LHIN Board of Directors’ meeting of Wednesday, May 25, 2016 be approved, as circulated.
CARRIED
1.2
Conflict of Interest
Maria reminded Members of the need to declare a Conflict of Interest with respect to any items that
could potentially place them in a conflict situation. There were no declarations. She requested that all
cell phones be turned off or muted during the meeting.
2.0
Consent Agenda
Maria reminded Board Members that the process is that they can ask questions for clarification from the
Consent Agenda, but if further discussion is required, the item will be pulled and added to the Regular Agenda.
Scott advised that all action items from the Board Minutes of Wednesday, April 27, 2016 have been addressed.
39
He noted that he had heard back from Peel Public Health regarding the Board’s inquiry regarding dental
screening in French Language speaking schools. Peel Public Health has confirmed that dental screening does
take place in both the Public and Catholic Boards’ French Language speaking schools in the Region of Peel.
There was a request to pull Item #2.3 ‘Explanation and Clarification of Actual Cost Per Weighted Case and
Expected Cost Per Weighted Case’ from the Consent Agenda for further discussion. It was agreed that the
item would be discussed immediately. Brock Hovey then reviewed the briefing note that had been included
which provided a bit of background on the current ‘trending’ of actual versus expected costs and volumes for
both William Osler Health System and Headwaters Health Care Centre. He noted that the LHIN is working with
the hospitals and the Ministry to better understand the factors that may be contributing to this trending. It was
noted that while the data presented in the graphs are correct, the Y-axis scale does not begin at “0” making the
change look much more significant than it actually is. For example, Headwaters Actual Cost per Weighted
cases has been increasing over the last number of years from $4,909 to $5,283; an increase of $374 over 2
years, but because the Y-Axis begins at $4,700 it makes this increase appear much more dramatic graphically.
Brock noted that he would follow up again with Ministry staff to try to gain further insight into what might be
driving this with respect to Headwaters, and will report back to the Board.
ACTION: Brock Hovey
MOVED by John McDermid and SECONDED by Pardeep Singh Nagra, that the Central West LHIN Board
of Directors approves the Consent Agenda, as amended.
CARRIED
3.0
Report of the Board Chair and Chief Executive Officer
3.1
Report of the Board Chair
Maria provided a brief update on some of her meetings and activities over the past month, including
updates on the status of LHIN Board recruitment, speaking engagements at various organizations
including the Rotary Club of Palgrave and preparations for the Board of Directors’ Retreat. She also
provided an update on the work of the Healthy Communities Initiative, noting that this group is moving
along very well.
Ken Topping advised that there is a group in Dufferin County called ‘Headwaters Community in Action’
(HCIA), who is doing some similar work and that he would forward their contact information to Maria.
ACTION: Ken Topping
3.2
Report of the Chief Executive Officer
Scott referenced his CEO Report, highlighting the following areas:
__________________________________________________________
Minutes of Central West LHIN Board of Directors’ Meeting held Wednesday, May 25, 2016
Page 2 of 5
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Health Links
There has been an exponential increase in the number of care plans related to Health Links in the
Central West in the last quarter, far exceeding most other LHINs. The outcomes continue to show
significant reductions in utilization of ED and inpatient volumes, as well as better ‘Quality of Life’.
Future evaluations will also include ‘Patient Experience’.
Palliative Care/End of Life
The LHIN anticipates hearing soon regarding the first round of approvals for residential hospice beds,
noting that based on a ‘population-based assessment of needs’, the Central West should have 36
Residential Hospice Beds. Currently we have ten, which is a significant gap.
Scott noted that Margaret Paan, has accepted the position of Director of the Central West Palliative
Care Network. Margaret has been an active member of the Central West Network and will be able to
transition easily into this role. She will have a dual reporting relationship to both the Central West
LHIN CEO and the Regional Vice President of the Carlo Fidani Cancer Centre at Trillium Health
Partners.
Hospital 2 Home
The Central West LHIN is one of six pilots that have been approved as part of the Home and
Community Strategy. The pilot provides bundled payment to William Osler, who then manages the full
continuum of care for 2 specific conditions, including the acute and short-term, post-acute community
care. While still early days, the pilot is seeing significant improvements in length of stay and hours of
care.
Headwaters Health Care Centre Groundbreaking
A ground breaking event for the $10 million Ambulatory Care expansion and Operating Room
upgrades at Headwaters Health Care Centre will take place May 26th. The community has waited a
very long time for these much-needed improvements.
Senior Director Recruitment
This process for recruitment of the Central West LHIN Senior Director of Health System Integration is
well underway with Knightsbridge, who have indicated that there has been considerable interest in the
position.
4.0
Board Education/Generative Dialogue
There was no scheduled Board Education/Generative Dialogue session this month.
5.0
Strategic Dialogue
5.1
2015-2016 Annual Report
Board Members reviewed a first draft of the 2015-2016 Central West LHIN Annual Report and provided
preliminary feedback. Scott advised that the document follows the usual required format and is due for
__________________________________________________________
Page 3 of 5
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submission to the Ministry of Health and Long-Term Care by June 30, 2016. Board Members were asked
to provide feedback or suggested changes by June 10th. The document will be revised accordingly, and
a final Draft will be brought to the June Board Meeting for approval.
5.2
2016-2017 Annual Business Plan
A final annotated draft of the 2016-2017 Annual Business Plan (ABP), incorporating changes requested
by the Ministry was reviewed by Board Members and a brief discussion followed. The final ABP is due
to the Ministry of Health and Long-Term Care by June 17th. .
5.3
Executive Leadership Development in the Central West LHIN
Scott advised that the Executive Leadership Development Program has now completed three modules
with approximately 45 participants at each, for a total of approximately 135 graduates including several
primary care physicians, many of them who are highly engaged and now attending Governance &
Leadership and other LHIN events. He noted that it has been a highly successful program and
requested the Board’s approval of a 4th module, subject to the LHIN receiving the Community Funding
and having availability of one-time funding. A brief discussion followed.
6.0
MOVED by John McDermid and SECONDED by Ken Topping, that the Central West LHIN Board of
Directors approves the continuation of the Central West Executive Leadership Development
Program for 2016-2017, subject to receiving our Community Funding and having availability of
one-time funding.
CARRIED
Fiduciary Dialogue
6.1
Verbal Report of the Finance & Audit Committee
Adrian Bita provided an overview of discussions at the Finance & Audit Committee meeting Tuesday,
May 24, 2016 noting that the Committee had reviewed the Post Audit Report and audited financial
statements with Steve Stewart from Deloitte. Steve had advised that it had been a very clean audit,
that good internal controls were in place, and that the LHIN staff had been very cooperative throughout
the process.
Adrian advised that as per usual practice, all staff had been excused from the meeting for a brief
discussion with Committee Members and the Auditor only.
MOVED by Jeff Payne and SECONDED by Lorraine Gandolfo, that the Central West LHIN Board
of Directors approves the 2015-2016 Central West LHIN Post Audit Report and audited financial
statements for the period ending March 31, 2016, as circulated.
CARRIED
__________________________________________________________
Page 4 of 5
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Adrian advised that Committee Members had also reviewed the final 2015-2016 Funding Allocations
and were very pleased that staff had been able to move the majority of the funding out to the
health service providers very quickly this year. Staff were congratulated on their efforts.
6.2
Verbal Update from Quality Committee
John McDermid advised that the Quality Committee had not met in May, but that he had recently
participated in interviews for the Clinical Quality Lead position, announcing that Dr. Tamara
Wallington had been the successful candidate. He noted that Dr. Wallington is a staff physician at
William Osler Health System in the Department of Medicine, and Corporate Medical Director for
Quality and Patient Safety. In her new role, she will have the opportunity to influence positive change
that will result in improved patient outcomes, experience of care and value for money with the ultimate
goal of aligning the Quality agenda while engaging Central West LHIN communities to build on and
help accelerate existing efforts to promote a culture of quality.
7.0
In-Camera Session
MOVED by Ken Topping and SECONDED by Pardeep Singh Nagra that, at 3:50 p.m., the Central West
LHIN Board of Directors consider Matters of Public Interest in a Closed Session as set out by the Local
Health Integration Act, 2006, s.9(5)(a), and further, that Staff Members in attendance be invited to stay
for this portion of the meeting.
CARRIED
MOVED by John McDermid and SECONDED by Adrian Bita that, at 4:20 p.m., the Central West LHIN
Board of Directors’ meeting be moved Out-of-Camera and back into the Regular Session.
CARRIED
8.0
Adjournment of Board Meeting
MOVED by Suzan Hall and SECONDED by Jeff Payne, that there being no further business for
discussion, that the Central West LHIN Board of Directors’ Meeting of Wednesday, May 25, 2016 be
adjourned at 4:20 p.m.
CARRIED
_____________________________
Maria Britto, Board Chair
_________________________
Scott McLeod, CEO
__________________________________________________________
Page 5 of 5
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MINUTES OF THE FINANCE & AUDIT COMMITTEE MEETING
OF THE CENTRAL WEST LOCAL HEALTH INTEGRATION NETWORK
Held Tuesday, May 24, 2016 at 6:00 p.m
Committee Members Present:
Gerry Merkley (Committee Chair), Ken Topping (Member), Maria Britto (Board Chair), John McDermid (Vice
Chair), Pardeep Singh Nagra (Member), Adrian Bita (Member)
Staff Members Present:
Scott McLeod (CEO), Brock Hovey, Michele Williams, Michael Buchert, Tellis George
Guest:
Steve Stewart, Partner, Deloitte
1.0 Call to Order & Declaration of Conflict of Interest
Gerry Merkley, Committee Chair and all staff members attended the meeting at the LHIN Office. The rest
of the Members and Steve Stewart from Deloitte, participated via Teleconference as had been agreed to
earlier in the day. Gerry called the meeting to order at 6:00 p.m. and asked if there were any declarations
of Conflict of Interest. There were none.
MOVED by Pardeep Singh Nagra and SECONDED by Adrian Bita, that the Regular Agenda, as
circulated, be approved.
CARRIED
1.2 Conflict of Interest
Gerry asked Committee Members if there were any declarations of Conflict of Interest with respect to
agenda items. There were none.
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2.0 Approval of Previous Minutes
2.1 Minutes of Finance & Audit Committee Meeting held Monday, March 21, 2016
MOVED by John McDermid and SECONDED by Adrian Bita, that the minutes of the
Finance & Audit Committee meeting of Monday, March 21, 2016 be approved, as circulated.
CARRIED
3.0 2015-2016 Funding Allocation Summary
Brock and staff members provided an overview, for information, of the 2015-2016 Funding Allocation
Summary, which provides a breakdown of 2015-2016 funding to health service provider organizations
from the period April 1, 2015 to March 31, 2016.
A brief discussion followed and Gerry commended the staff on getting such a significant amount of money
out to the health service providers so quickly this year, recognizing the amount of time and effort it would
have taken to get this done. She expressed how great it was for her to see this happen as the outgoing
Chair of the Finance & Audit Committee and encouraged the LHIN to continue this practice in the future.
4.0 2015-2016 Post Audit Report and Audited Financial Statements ending March 31, 2016
Gerry welcomed Steve Stewart, Partner with Deloitte, to the meeting. Steve provided an overview of the
2015-2016 Central West LHIN audit process, noting that there had not been any significant deficiencies
and that overall, there was a very good internal control system in place. He advised that there had not
been any restrictions placed on the Auditors by LHIN staff and there had been full cooperation from both
LHIN management and staff prior to and during the audit process.
Steve answered various questions from Members and at this point in the meeting (6:50 p.m.), the meeting
was moved In-Camera for a brief discussion with Committee Members and the Auditor only. All staff were
excused from the meeting. At 6:55 p.m., the meeting moved Out of Camera and back into the open
session with all staff returning.
Gerry thanked all staff for their efforts throughout the audit process, noting that the Committee was very
pleased with having such a clean audit report. She congratulated Brock Hovey, Michael Buchert, Tellis
George, Alan Hernandez, and the rest of the Finance Team for their good work.
__________________________________________________
Page 2 of 3
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MOVED by Adrian Bita and SECONDED by John McDermid, that the Finance & Audit Committee
recommends approval of the 2015-2016 Central West LHIN Post Audit Report and Audited
Financial Statements for the period ending March 31, 2016 as circulated.
CARRIED
5.0 In-Camera Session
There were no recorded minutes of the brief In-Camera session that took place with the Committee
Members and the Auditor between 6:50 p.m. to 6:55 p.m.
6.0 Adjournment of Meeting
MOVED by Pardeep Singh Nagra and SECONDED by Adrian Bita, that there being no further
business for discussion, that the Finance & Audit Committee meeting be adjourned at 7:00 p.m.
CARRIED
___________________________
Gerry Merkley, Chair
Finance & Audit Committee
__________________________________________________
Page 3 of 3
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MINUTES OF THE GOVERNANCE COMMITTEE MEETING
OF THE CENTRAL WEST LOCAL HEALTH INTEGRATION NETWORK
HELD THURSDAY, APRIL 14, 2016 AT 5:00 P.M.
Lorraine Gandolfo (Committee Chair), Maria Britto (Board Chair), John McDermid (Vice Chair),
Ken Topping (Member), Suzan Hall (Member), Adrian Bita (Member), Jeff Payne (Member)
Staff Members Present:
Scott McLeod (CEO), Michele Williams (Board & CEO Liaison)
1.0 Call to Order & Declaration of Conflict of Interest
Lorraine Gandolfo, Committee Chair, called the meeting to order at 5:00 p.m. and asked if there were any
declarations of Conflict of Interest. There were none.
MOVED by Adrian Bita and SECONDED by Ken Topping, that the Regular Agenda for the Governance
Committee meeting of Thursday, April 14, 2016 be approved, as circulated.
CARRIED
3.0 Consent Agenda
3.1 Approval of Previous Minutes – Thursday, February 11, 2016
There were no errors or omissions noted in the previous minutes. Scott advised that all action items were
either underway or complete.
MOVED by Ken Topping and SECONDED by Suzan Hall, that the minutes of the Governance
Committee meeting of Thursday, February 11, 2016 be approved, as circulated.
CARRIED
4.0 2014-2015 Pan-LHIN Whole Board Evaluation – Comparative Results for the 14 LHINs
Committee Members briefly reviewed the comparative results for the 14 LHINs and Scott noted that this had
been circulated for information purposes only, as requested at a previous meeting.
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5.0 Central West LHIN 2014-2015 Whole Board Evaluation – ‘Opportunities for Development’ Action Plan
Committee Members reviewed the 2014-2015 Central West LHIN Whole Board Evaluation – ‘Opportunities for
Development Action Plan’ and a few specific areas that had been identified as potential areas for
development/action at the last Governance Committee meeting including:
-
A refresh on the current ‘Legislated Authority’ of the Board (will be scheduled for the September 2016 Board
Education session)
Completion of a ‘Risk Template’ related to the number of Board Members who will be leaving the Board this
year and the potential governance impact it poses for the Board (underway)
One-on-One Meetings with the Board Chair (underway)
6.0 Update on Central West LHIN Governance & Leadership Forum – Tuesday, April 26, 2016
Scott provided a brief overview of the proposed Agenda for the April 26th Governance & Leadership Forum
entitled ‘Creating a Culture of High Performance’, and based on the 5 Pillars of the Studer philosophy. He noted
that materials would be distributed to registered participants prior to the event for ‘pre-reading’. At this time,
there are approximately 90 people registered and a final email blast will be going out by the end of the week
along with the pre-reading materials. Central West LHIN Board Members will also be copied on the email.
7.0 Central West LHIN Board of Directors’ Retreat
Scott provided an update on planning for the May Board of Directors’ Retreat on ‘Patients First’, noting that the
date of Thursday, May 26, 2016 had been confirmed and will be combined with an afternoon Board Meeting on
Wednesday, May 25th with a dinner and farewell event for the three Central West LHIN Board Members who will
be retiring this year. He advised that preliminary discussions with John Whincup of Optimus SBR (who will be
Facilitating the Board Retreat) had led to a draft outline of what the day could look like, including some or all, of
the following elements:
-
Implications – structured review of potential legislative changes, key elements from ‘Patients First’, review of
the Rules of Engagement, and Ministry expectations
Gaps and Issues- identification of gaps and issues related to governance and oversight of operations
Prioritization – development of criteria and ranking of issues
Identification of Solutions and Actions – brainstorming session to identify solutions and begin identifying
actions (for example, Transition Plan, and work that needs to take place with the CCAC Board)
Action Planning – development of an initial Action Plan that identifies what needs to happen for the
Transition Plan to be implemented, what the next steps are for operations and what can be done now until
the legislation is enacted
Scott noted that work on the logistics with the off-site venue for both days are currently underway and that
further information including a draft of a Retreat Agenda would be circulated to Board Members in the next
couple of weeks.
_____________________________________________________________________________
Minutes of Central West LHIN Governance Committee Meeting held Thurs., April 14, 2016
Page 2 of 3
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8.0 Governance Policy & Bylaw Review
Scott provided a brief update on the review of LHIN Bylaws, noting that at the current time, they are still under
review. He advised that the Central West LHIN Governance Policy on ‘Priority-Setting and Decision-Making
Framework’, is in the process of a re-write by staff and will be brought back to the next Governance Committee
meeting for review and recommended approval.
9.0 Board Appointments
Maria provided a brief update on some of the ongoing discussions and challenges with the Board recruitment
process, reminding Committee Members that we had submitted our advertisement for three new Board Members
back in December 2015.
There was a brief discussion about the OIC process, and Committee Members requested that a copy of the PanLHIN Board Chair correspondence that had recently been sent to the Minister outlining some of the current
challenges with the public appointments process in addition to other governance items, be circulated to the full
Board.
Scott advised that a copy of the correspondence would be provided in the April Board package of materials.
ACTION: Michele Williams
MOVED by John McDermid and SECONDED by Jeff Payne that at 6:20 p.m., the Governance Committee
be adjourned.
CARRIED
_______________________
Lorraine Gandolfo, Chair
Governance Committee
_____________________________________________________________________________
Minutes of Central West LHIN Governance Committee Meeting held Thurs., April 14, 2016
Page 3 of 3
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Quality Committee
MINUTES
Date:
Time:
Location:
April 11, 2016
5:00 – 7:00 pm
Main Boardroom
LHIN Staff Present:
1.0
John McDermid (Chair), Maria Britto (Board Chair), Suzan Hall (Member), Jeff
Payne (Member), Ken Topping (Member), Cynthia Majewski (Volunteer), Bernard
Souche (Volunteer)
Scott McLeod, Brock Hovey, Nancy LaBelle, Jas Rai, Suzanne Robinson, Dave
Pearson
Call to Order and Declaration of Conflict of Interest
The meeting was called to order at 5:00 p.m. No conflicts of interest were declared.
2.0
Approval of Agenda
Approval of the Agenda for the April 11th, 2016 Meeting
MOVED by Jeff Payne and SECONDED by Suzan Hall that the Agenda be approved as circulated.
CARRIED
3.0
Approval of Minutes
Approval of Minutes of the March 7th, 2015 Meeting.
MOVED by Jeff Payne and SECONDED by Suzan Hall that the Minutes of the March 7, 2016 meeting be approved as
circulated.
CARRIED
4.0
Update on System Level Aims
The Chair thanked Jeff Payne for chairing the meeting last month. The Chair asked members if they had any comments about
meeting with the constituents. Members felt the meetings were very productive and provided a lot of good information.
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Brock introduced Suzanne Robinson and Dave Pearson (staff) to provide an update on System Level Aims.
Suzanne addressed Improve Access to Mental Health and Addiction Services. Data shows that repeat Emergency Department
(ED) visits within 30 days for mental health have improved over the last year with a downward trend, we are now at 14.1%, showing
a downward trend compared to the provincial target of 16.3%. We have achieved a 10% change. Data indicates that ED visits
have reduced by 60% with the InSTED program in place. Also, clients recommended by Crisis Services for an ED visit are triaged
as requiring acute care and are admitted, showing that the need for an ED visit was appropriately assessed and the visit was
necessary. Substance abuse metrics have not changed. We are reviewing data available from the MOHLTC, which specifically
shows there are about 30 individuals who were identified as those with repeat visits. Data indicates that 75-80% repeat visits are
related to alcohol use.
Members asked if there was any visibility to the numbers of mental health patients visiting ED, specifically beyond 30 days. Suzanne
advised that at this time there is no tracking above 30 days. As for the overall volume, numbers are steady, and there is a low
number at Headwaters. Volumes are holding but not sure beyond 30 days.
Suzanne informed members that there is no indication at this time that the Syrian refugees have had any impact on this number,
have not seen any data that reflects that.
At this time Suzanne turned it over to Dave Pearson.
Dave addressed Improve System Navigation and informed members that by March 31st we are at 3,000 completed Health Links
(HL) care plans for identified complex patients. Dave did seek some clarification from leadership that the target will remain at
10,000 going forward. The number is important, as HL is about system transformation. Dave informed members that we continue
to support identification of HL patients and using Suzanne’s previous example, to look at how to support appropriate population
groups such as mental health (as well as palliative care, primary care and Telehomecare) to ensure patients such as those 30
individuals with repeat visits have completed, coordinated care plans.
Members asked why we chose 10,000 care plans. Dave advised that based on a data scan, we know we have around 40,000
clients that meet the definition of complex patients. Some of those patients needs may become less complex, and some will pass
on - 10,000 seemed like a fairly good stretch target to begin to address these numbers.
The plan is to continue to build the number of completed coordinated care plans for complex patients and numbers show that
Brampton and Bramalea have improved, Bolton is a little behind, and Etobicoke is doing very well with almost 900 care plans in the
last quarter.
From a Pan-LHIN perspective, there is much more focus on HL provincially. HQO has looked at how we (Central West LHIN) do
care rounds and how we use care tools, as we are ahead of other LHINs in our numbers. The idea is to share successes so we
can all learn from each other.
Dave informed members that as care plans are developed, HSPs can monitor and trend hospital utilization by HL patients to
determine decreased reliance on the ED. Dufferin did this for the first 200-300 people, and it resulted in a 40% reduction in length
of stay. As these are complex patients, you will notice at 60-90 days there is a return to the ED.
5.0
Overview of Quality at the Central West LHIN
Brock reminded the members of the Health Quality Ontario (HQO) Quality Dimensions. A health system with a culture of quality
that is:
Central West LHIN... Making Healthy Change Happen
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



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Safe
Effective
Patient-centred
Efficient
Timely
Equitable
Brock provided an overview of the Central West LHIN Quality Map in a schematic drawing to demonstrate how quality concepts at
the provincial, regional and local levels fit together to drive quality across the system.
Further discussions focused on quality structures within Central West and Brock advised that public representation will be at the
Advisory Groups i.e. Regional Quality Table. In addition, HQO has recommended a member of the public be involved and the
CEO advised members that in the Patient’s First legislative we will expect to see a patient/family counsel.
6.0
Third Party Health Service Provider (HSP) Survey
Nancy LaBelle provided an overview of the Health Service Provider (HSP) Survey. Establishing a quality framework was ranked
lowest in importance of LHIN activities by organizations. Health system funding and planning scored very high.
There is an opportunity for HSPs at the regional level, to align quality across the system provincially and locally by developing an
infrastructure.
There is an opportunity during the HSP Quality Forum to lever collaboration and gain knowledge so that we can drive an agenda
to result in some real collaboration with the HSPs. HSPs are learning from each other, and the fact that we now require HSPs to
be accredited, quality is moving up on the importance list. It was noted that there are only 13 HSPs not accredited at this time,
there may be one or two that may not be accredited by 2017. HSPs agree that this is a lot of work but it is worth doing.
Quality initiatives should be shared publically, via a public facing document. Brock advised that a couple of years ago we published
a document called “spotlight on quality”, and we have a section in every newsletter on quality. One of the criticism about quality is
that it gets siloed. Every core action group should have a quality agenda item.
It was suggested a report be sent out to our HSPs regarding our roadshow, this can be added as part of the next newsletter.
7.0
Patient Experience in the Central West LHIN
Nancy LaBelle provided a summary of what happened in the province and in Central West LHIN.
This is very high on the provincial agenda, as documented in the Auditor General Report. It is a system level aim for us and is in
our IHSP and Annual Business Plan.
From our meetings with HSPs it was evident that they are very engaged, there are some commonalities, and differences to develop
across the LHIN on these measures.
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The Hospitals have a new Regional Chief Patient Experience Officer in place. Hospitals still use the NRC tool which has a delay
in getting data, so staff follow up with a telephone call to patients in order to get real time information. Hospitals are focusing on
the “top box” scores which are scored as yes or definitely for “would you recommend this hospital” questions, this is new for 2016/17.
The CHCs quality dimensions are focused on being timely and patient-centred. The priority primary care indicators are:
 timely access to primary care;
 patient involvement in decision in care;
 primary care provider spending enough time with them; and
 opportunity to ask questions.
CHC’s conduct regular client satisfaction surveys, via focus groups or surveys accessible via an iPad placed in waiting rooms.
CCAC’s asks three specific questions:
 overall rating of care and service provided;
 rating of management or care provided by a Care Coordinator; and
 rating of service provided.
In Long-Term Care (LTC) we heard that client satisfaction measurement is legislated, i.e. annual surveys of residents and their
families. There are a variety of tools used for surveys in LTC homes, for example, Sienna homes are using Promatura – it has
quality dimensions attached to the questions, a very good tool. In 2012 the OLTCA did a survey to assess survey methodologies.
CSS - these agencies are not required to submit QIP to HQO at this time. The MSAA does outline requirements to measure client
satisfaction in three areas:
 overall care received
 say about care and treatment
 treated with dignity and respect
It was noted that there’s a component of healthcare we are not responsible for, people are going into private clinics to get tests but
don’t get results in a timely manner, we have no control over these clinics.
We want to align our work at the provincial level, as well as the local level
Brock informed members that there are common threads here as we are looking at patient experience and patient satisfaction.
HQO has tabled where they are heading provincially and we are trying to blend our efforts with theirs to avoid duplication while
remaining focused on a Central West solution.
Brock advised members that all HSPs said they would be interested in a collaborative survey, there is an opportunity to collaborate.
Although some HSPs have been using their surveys for years, there is an opportunity to transition from patient satisfaction to patient
experience, so HSPs do not lose the continuity of information.
The Chair thanked Nancy for the presentation.
8.0
Central West LHIN Quality Event and Quality Awards
Two briefing notes were provided to members. Discussion followed about sponsoring the Central West LHIN to profile the work
being done.
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Discussion followed regarding collaborating with other LHINs. Mississauga Halton LHIN just had an event in September, they had
a budget of $32,000 and done in conjunction with HQO. Brock informed members that a number of LHINs have already done or
have events scheduled in the next few weeks.
The Central West plans to have an all-day session.
The Chair suggested we bring in community leaders, invite service clubs, all kinds of people to talk about quality, bring in a speaker,
but don’t want it to be another G2G. Also an opportunity to invite politicians. We should use this forum to give our HSPs a chance
to talk about their programs, so community can hear what is going on locally in healthcare.
The CEO suggested that our physicians be involved too. There is great value in partnering as we don’t have a lot of cross-boundary
joint providers.
Brock advised that South West LHIN’s event attracts 500+ people, they have been doing this for a number of years.
It was agreed that there is a lot of work for Staff to do to organize this forum, engaging a top speaker, bringing in new content, tools
as well as development of criteria, and panel.
Discussion about the Quality Award followed, this would be part of the quality event to recognize our providers across the different
sectors. Other LHINs have already done this type of event/award. We will get some feedback, what award is it going to be, is it
strictly quality or leadership in healthcare. It was suggested that criteria regarding diversity and dealing with the ethnic communities
would fall under this award.
Brock advised that the Committee will look to the Chair to recommend a couple of Committee Members to sit on a small panel. We
would need to engage an expert facilitator, with a nominal budget.
9.0
Updates/ References
Interviews will be conducted on May 2nd for the Quality Clinical Lead, HQO will have a representative on the interview panel. The
Quality Clinical Lead will join this committee. LHIN-wide, three Leads have been appointed, a few are ready to announce, and each
LHIN is at a different level.
Status of the Regional Quality Table – this table brings a number of clinicians to the table, so the Quality Clinical Lead will be at this
table and keep this committee in the loop on what’s going on with this group.
10.0 Work Plan Update
The work plan and status of each activity/deliverable was reviewed with the members.
11.0 Date of Next Meeting
Date to be confirmed. May 9th, 2016 or June 13th at 5:00 pm, to be held at The Central West LHIN.
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Brock provided a brief overview of the key deliverables which included:
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An RFS to engage an event planner
Interview and select the Clinical Quality Lead
Establish Clinical Quality Table and HSP Quality Leaders Forum
Establish task groups for patient experience and quality awards
MOVED by Suzan Hall and SECONDED by Jeff Payne that the Quality Committee Meeting of Monday, April 11, 2016, be
adjourned at 7:30 p.m.
CARRIED
________________________________________
John McDermid, Committee Chair
Quality Committee
Central West Local Health Integration Network
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BOARD OF DIRECTORS' MEETING - WED., JUNE 22, 2016 - REPORT OF BOARD CHAIR AND CEO
CEO Report to the Central West LHIN
Board of Directors
June 22, 2016
1. Build Integrated Networks of Care
1.1 Health Links and Primary Care

With the recent recruitment of an Integrated Decision Support Consultant that supports the Central West Health
Links there is new capacity to monitor the outcomes related to Health Links. A recent report, completed in May
reviewed the 6-month pre and post hospital utilization of 606 patients with care plans developed between April 1 st
and September 30th, 2015.

A pre/post analysis of Inpatient (IP) and Emergency Department (ED) utilization was completed. The results show
a decrease in IP utilization of 31%, while the average length of stay remained consistent at ten days. ED visits also
dropped dramatically by 29%.

Over the coming months additional outcomes will be monitored and made available to the Health Link Leads and
Leadership that will demonstrate additional outcomes and impact for complex patients in the Central West LHIN.

Leads and co-leads met with the LHIN on June 10th to develop a Health Links budget for 2016/17, the focus of the
budget will be to continue to make gains in completed care plans while maximizing the use of existing community
and partner resources.
1.2 Telemedicine and Telehomecare

The Central West LHIN’s Telemedicine and Telehomecare Advisory Steering Committee met on May 27th and
reviewed the current status on implementing and integrating virtual care in Health Links and Mental Health. In the
Health Links environment, over 100 telemedicine events have occurred since its launch in March and there is positive
reception and adoption of the technology.
In areas of acute mental health, telemedicine has been integrated into psychiatry services provided by William Osler
Health System (Osler) to Headwaters Health Care Centre’s ED (HHCC), preventing unnecessary patient transfers
from Orangeville to Brampton. Telemedicine has become an effective tool in Child and Adolescent Mental Health
services by enhancing the continuum of care across multiple sectors. In areas of community mental health, virtual
care has been well integrated into addiction treatment, especially among methadone-prescribing physicians and the
Central West LHIN Narcotics Strategy multi-disciplinary outreach team. Community mental health providers are
utilizing telemedicine to increase access to psychiatry services and psycho-educational group therapy. Overall, the
Mental Health and Addictions therapeutic area of care currently represents 92% of all telemedicine activity within the
Central West LHIN. LHIN staff continue to review organizational telemedicine plans submitted by community Health
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Service Providers (HSPs) and are working to close the gap in understanding virtual care solutions. The LHIN, in
partnership with HSPs and the Ontario Telemedicine Network (OTN), will continue to implement and integrate
telemedicine solutions in the areas of Health Links, Palliative Care, Mental Health and Addictions and, starting this
fiscal year, virtual care will be integrating into areas of Chronic Disease Prevention and Management.

The Regional Telehomecare (THC) program has enrolled 1,840 patients into the program and currently 246 patients
are being monitored. Provincially, Ontario’s THC program for Congestive Heart Failure (CHF) and Chronic
Obstructive Pulmonary Disease (COPD) has demonstrated consistent outcomes with greater than 50% reductions
in hospital ED and IP visits for over 9,000 patients. Scott McLeod, is a member of the Provincial Telehomecare
Executive Steering Committee along with two other LHIN CEOs, Infoway Regional VP and OTN CEO. The Executive
Steering Committee is chaired by Nancy Naylor, Associate Deputy Minister, Delivery and Implementation at the
Ministry of Health and Long-Term Care (MOHLTC). Locally, the Regional Program continues to build on the
integration of THC in Assisted Living settings and will expand this reach over the next fiscal year.
1.3 Home and Community Care Renewal

Bill 210, the Patients First Act, was introduced into the legislature on Thursday, June 2nd. If passed, this legislation
will amend 20 different Acts, including significant change to the Local Health System Integration Act (LHSIA). The
intention of the changes is to give patients and their families faster and better access to care by placing them at the
center of an integrated system. The Patient’s First Act would give LHINs an expanded role most notably in the areas
of primary care and home and community care.

Health System Integration staff reviewed and provided comment on the MOHLTC first draft of the Levels of Care
(LOC) document. This initiative is in response to a finding by the Auditor General of Ontario of significant variation
in access and quality of home care services across the province. The goal of the LOC initiative is to ensure that
Ontarians receive consistent high quality home and community care regardless of where they live. The MOHLTC
conducted community engagements with patients and their families, providers and received input from an Expert
Panel on Home and Community Care. Once complete, the LOC Framework will provide patients and their families
a transparent, easily understood roadmap of service eligibility. The LOC Framework will allow care coordinators to
evaluate patient complexity and develop equitable care plans while maintaining clinical discretion and flexibility. Next
steps include continued engagement including workshops leading to a piloting of the Framework beginning in the
summer of 2016.

The LHIN received $100,000 in Community Infrastructure Renewal Funds. The purpose of these funds is to assist
eligible community-based HSPs to address small capital projects that relate to health and safety concerns,
accessibility requirements and/or patient comfort issues. LHIN staff reviewed building survey results and
recommended funds be allocated to Peel Cheshire Homes Brampton to replace the Heating Ventilation and Air
Conditioning (HVAC) unit and to Peace Ranch to replace baseboard heating and safety rails.
1.4 Mental Health and Addictions Services

The Mental Health and Addictions Services Core Action Group (CAG) met on June 1st and discussed their Work
Group’s final report on the System Access Model. It included a two-year implementation plan and business process
maps for how individuals access information about services, proceed to intake/registration, and be matched and
transitioned to services. CAG members had detailed, small group discussions to decide endorsement of the
recommendations to operationalize the model. The CAG is expected to formally accept the report in its entirety at a
Central West LHIN... Making Healthy Change Happen / Le RLISS du Centre-Ouest... Favorisons la santé
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July meeting. A key factor about the phased implementation is Patients First i.e. spreading the access model beyond
mental health and addictions to serve residents in sub-LHIN regions.
Among the projects underway that advances implementation of the model, are training on the new provincial
addictions screening tool and on the Ontario Perception of Care client experience survey, adoption of a tool to
determine required level of care, and refreshing the comprehensive inventory of individual and group services for
upload to an existing resource database e.g. Connex Ontario and/or Central West Healthline.

LHIN staff continue to monitor and support the integration of services in Dufferin County, primarily a transfer from
Waterloo Wellington to the Peel Branch of the Canadian Mental Health Association (CMHA). Further to the Board
Briefing Note of March 23rd, 2016, services were categorized as Group A and B. The transfer of Group A services
and associated funding is underway with a detailed implementation plan being followed by CMHA Peel. The services
known as Group B requires the involvement of the LHIN because there are multiple funding sources implicated. As
such, Performance, Finance, and Integration staff are helping to revise funding arrangements through the
Mississauga Halton LHIN with one of their HSPs, Dufferin County, and Alzheimer’s Society of Dufferin. In keeping
with current agreements with providers in the Central West LHIN, the remaining Group B services transfer will be to
the CMHA Peel Branch for seniors and Osler for eating disorders.

LHIN staff continue to facilitate the integration of Peace Ranch and SHIP (Supportive Housing in Peel). This will
result in Peace Ranch transitioning under the governance of SHIP. The process was delayed as Peace Ranch
managed the Executive Director’s resignation and resulting vacancy. Based on a draft submission completed in
March, the LHIN, SHIP and Peace Ranch in mid-June completed a more comprehensive Implementation Plan. It
articulated the findings of their due diligence and the recommendation to proceed, considering the timelines required
to complete the legal process and to properly manage human resources. The anticipated base and one-time costs
of the integration were included and are under review by LHIN staff.

An update to last month’s report on Homes for Special Care (HSC), there is only one remaining in the Central West
LHIN. MOHLTC had indicated there were three however one is in another LHIN. A second one in Brampton was
closed as the operator is recently deceased and the lease terminated. SHIP informed the LHIN of the closure and
confirmed that they helped to transition the clients who resided at this home. The one HSC in the LHIN is in Caledon
and has a capacity to serve 46 clients. LHIN staff remain engaged in the MOHLTC modernization of the HSC
program through the representation by four LHINs on the provincial work group.
1.5 Palliative and End-of-Life Care

The LHIN welcomed Margaret Paan to the role of Central West Palliative Care Network Director on June 6 th.
Margaret will now lead the efforts to evolve the current network into one that is compatible with the emerging
directions from the Ontario Palliative Care Network.

LHIN staff continue to explore possibilities for the development and operation of a new residential hospice.
Discussions have been held with existing hospice operators, municipalities, and service clubs to gage interest and
capacity to undertake this challenging initiative.

The Ontario Palliative Care Network (OPCN) is continuing its work on standardizing the approach to palliative care
across the province. The OPCN has produced and disseminated draft Terms of Reference for local Palliative Care
Networks, Role Descriptions for Network Directors and Clinical Leads, and recommendations for standardized
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terminology. The OPCN is scheduling sessions with each LHIN over the course of the summer to discuss local
readiness for the transition to the new structure.
1.6 Long-Term Care Renewal

The Region of Peel is moving forward with plans for the redevelopment of the Peel Manor site. Region staff have
shared their desire to introduce a PACE model to this site which will incorporate the rebuilt Long-Term Care (LTC)
home along with other services for seniors such as assisted living, adult day programs, meals on wheels, congregate
dining, etc. The Region is hosting a workshop on the PACE model in June which LHIN staff will contribute to.
2. Drive Quality & Value
2.1 Improve the Patient Experience

Health Quality Ontario is collaborating with clinical experts, patients and caregivers in the development of quality
standards to support the delivery of best-evidence care. A quality standard is a concise set of easy-to-understand
statements outlining the best care possible for patients with selected conditions, based on the best available
evidence. As quality standards are developed and used, they will:
o help patients and families know what to expect (and ask for) in their care
o help health care providers know what care they should provide
o help organizations measure, assess and improve performance in caring for patients with these conditions
2.2 Quality and Innovation

Following a competitive process, Dr. Tamara Wallington has been named the successful candidate for the role of
Central West LHIN Clinical Quality Lead. In this role, Tamara will have a dual reporting relationship to the Chief,
Clinical Quality at Health Quality Ontario (HQO), and the Chief Executive Officer of the Central West LHIN. Tamara
is trained in internal medicine, public health and preventive medicine and is a staff physician at Osler in the
Department of Medicine. She is also the Corporate Medical Director for Quality and Patient Safety. Tamara brings
significant experience to this new role of Clinical Quality Lead, having led numerous quality improvement initiatives
in recent years. She is passionate about the delivery of high-quality, evidence-based care and we look forward to
working with her to advance the quality agenda in Central West.

With the Clinical Quality Lead now in place, planning for a Regional Quality Table can now move forward at an
accelerated pace. Chaired by the Clinical Quality Lead, the Regional Quality Table has a mandate to engage
providers in a culture of quality care, improve partnerships, foster innovation, build capacity, facilitate knowledge
exchange and develop and implement an integrated regional quality plan. Through the summer months, a
membership selection process will be initiated along with planning for the inaugural meeting of the Regional Quality
Table in September.

At the same time, planning for a similarly structured table called the HSP Quality Leaders Forum will take place.
Intended to work in parallel with the Regional Quality Table, this Forum will bring together quality leaders from Central
West HSPs to collaborate, plan and support system-level quality initiatives. It will be chaired by the Central West
Quality Lead with an inaugural meeting also expected in September.
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
With the tabling of the Patients First legislation, impacts to existing legislation, including the Excellent Care for All
Act (ECFAA) are expected. Monitoring changes in requirements to remain in compliance with the legislation will
remain a key focus so expectations can be communicated and met by Central West HSPs.
2.3 Health System Funding Reform (HSFR)

The Central West LHIN continues to anticipate receiving the Central West CCAC 2016/2017 HSFR results. The
MOHLTC has indicated the results should be released shortly. Community Investment funding has not been released
to the LHIN, and is anticipated shortly. Central West LHIN staff has prepared for the release of funds.
2.4 Enabling Technology integration

ConnectingGTA (cGTA) – As the first of three regional integration hubs being created in Ontario, ConnectingGTA
supports eHealth Ontario’s clinical priorities and accelerates the delivery of electronic health records by integrating
electronic patient data from across six LHINs – Central, Central East, Central West, Mississauga Halton, Toronto
Central, and North Simcoe Muskoka. The cGTA solution houses hospital reports including:
o visit information
o ED reports
o Discharge Summaries
o Medication Profiles
o Allergy Information
o Consult reports along with CCAC information including visit info, referral info, service info, assessments,
diagnostic imaging reports and lab results.

Forty-eight Early Adopter sites are now live with over 41,000 enrolled users. Osler is an early adopter site and has
enrolled over 4,700 users. Users who actively use cGTA increases every week. HHCC is in rollout one of the
expansion phase. They are currently contributing data to the cGTA data repository and are on target to be able to
view data from all participating sites by August 2016. In addition to the hospital activity, two Family Health Teams
(FHT) (Queen Square and Wise Elephant), the Region of Peel, Central West CCAC and Kipling Acres currently
have access to view data using cGTA. Eight additional Central West LHIN HSPs are also included in the cGTA
expansion phase representing and are targeted to go-live with viewing this fiscal year.

Project Management Office (PMO) Business Plan – Enabling Technologies for Integration (ETI) 2016-17 –
The Enabling Technologies for Integration business plan includes details for how the Central Ontario LHINs will
leverage the ETI PMO funding to advance the creation of the Electronic Health Record (EHR) across the Central
Ontario Cluster and within the Central West LHIN. The MOHLTC has completed its review of the first draft of the
business plan and has provided feedback along with requests for additional information. The changes recommended
by the MOHLTC have been incorporated and the requested additional information provided. It is expected that the
MOHLTC will complete review activities and approve the business plan by the end of June 2016.
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3. Connect & Inform
3.1 Communications and Community Engagement

Press Releases/Publications
Ontario Introduces Legislation to Further Improve Patient Access and Experience - Patients First Act Would
Deliver on Action Plan for Health Care: Ontario has introduced new legislation that would, if passed, improve
access to health care services by giving patients and their families faster and better access to care and putting them
at the centre of a truly integrated health system. Read more…
Patients First: Reporting Back on the Proposal to Strengthen Patient-Centred Health Care in
Ontario: As outlined in Ontario’s Patients First: Action Plan for Health Care, the province is committed
to putting patients at the centre of a truly integrated health system by giving them better access to care
no matter where they live. As part of this plan, Ontario released Patients First: Proposal to Strengthen
Patient-Centred Health Care in Ontario for feedback and consultation. Ontarians were invited to provide
feedback on the discussion paper a variety of ways, including in-person meetings, email, web surveys
and webinars. Patients First: Reporting Back on the Proposal to Strengthen Patient-Centred Health Care
in Ontario is a summary of what the ministry heard. It will inform next steps in giving patients better access
to care no matter where they live.
Ontario Launches $222 Million First Nations Health Action Plan - Province Supporting Indigenous Health
Care: Ontario is investing nearly $222 million over the next three years to ensure Indigenous people have access to
more culturally appropriate care and improved outcomes, focusing on the North where there are significant gaps in
health services. Read more…
Announcement - Dr. Tamara Wallington, MD, FRCPC : Following a competitive process, it is our great pleasure
to announce Dr. Tamara Wallington as the successful candidate in the role of Central West Local Health
Integration Network (LHIN) Clinical Quality Lead. Read more…

Meetings/Events (Past)
Communications provided support for the following meetings/events as required:
Thursday, May 26th, 2016
Tuesday, May 31st, 2016
Thursday, June 2nd, 2016
Wednesday, June 8th, 2016
Sunday, June 12th, 2016
Monday, June 13th, 2016
Monday, June 13th, 2016
Thursday, June 16th, 2016
Thursday, June 16th, 2016
Tuesday, June 21st, 2016
HHCC ground-breaking ceremony: Remarks provided by John McDermid
Ontario Chiropractic Association: Presentation provided by Mark Edmonds
South West LHIN Quality Symposium: Attended by Tom Miller
Palgrave Rotary: Presentation by Maria Britto
Catholic Family Services of Peel Annual High Tea: Attended by Maria Britto
Family Services of Peel AGM: Attended by Suzan Hall
Central West CCAC AGM: Remarks provided by Maria Britto
Peel Halton Dufferin Acquired Brain Injury Services 5th Anniversary Celebration
of Orangeville Office: Remarks provided by Ken Topping
CANES AGM and Community Engagement Forum: Attended by Suzan Hall and
Mark Edmonds
Caledon Community Services AGM: Attended by Adrian Bita, Scott McLeod
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Tuesday, June 21st, 2016
Wednesday, June 22nd, 2016

and Brock Hovey
HHCC AGM: Remarks provided by Maria Britto. Also attended by John
McDermid, Ken Topping and Suzan Hall
William Osler Health System AGM and Etobicoke General Ground Breaking:
Remarks provided by Maria Britto. Also attended by Suzan Hall
Meetings/Events (Future)
Communications will provide support for the following upcoming meetings/events as required:
Saturday, June 25th, 2016
Tuesday, June 28th, 2016
Wednesday, June 29th, 2016
Peel Cheshire Homes AGM: Remarks provided by Maria Britto. Also attended by
Suzan Hall
Friends and Advocates Peel AGM: Attended by Adrian Bita
Caledon Meals on Wheels AGM: Remarks provided by Maria Britto. Also
attended by Ken Topping, Adrian Bita and Brock Hovey

Annual Business Plan 2016-2017 | Following approval as revised at the May Board of Directors Meeting, the 20162017 Central West LHIN Annual Business Plan was finalized in both English and French, and submitted to the
MOHLTC ahead of the requested deadline of Friday, June 17th, 2016.

Annual Report 2015-2016 Website | Subsequent to the May Board of Directors meeting, edits received from
members of the Board and Senior Management Team have been incorporated into a final version. This version,
with its accompanying Briefing Note, is now presented to the Central West LHIN Board of Directors for final review
and approval. Submission deadlines for LHINs to submit their 2015-2016 Annual Reports to the MOHLTC are…
English: June 30th, 2016 and French: August 31st, 2016.
3.2 French Language Services

The French Language Services Coordinator and the Director, Health System Integration responsible for mental
health met with Josée Roy, Reflet Salvéo’s new Planning Agent responsible for mental health. This was an
introductory meeting to align the work of Reflet Salvéo with the Central West LHIN’s Integrated Health Services Plan
2016-2019 and Annual Business Plan 2016-2017.

The French Language Services Coordinator participated in the launch of Reflet Salvéo’s inter-LHIN work group on
promoting safe spaces within HSPs. The work follows a recommendation from Reflet Salvéo’s Annual Advisory
Report and a study done by the Entity on the needs of the Francophone LGBTQIA* Community (Lesbian, Gay,
Bisexual, Transsexual, Queer, Intersex, Asexual) in the Greater Toronto Area.
3.3 Aboriginal Services

The Annual Provincial Aboriginal LHIN Network conference took place in Grand Bend and Kettle Point First Nation
from May 17th to 19th. Priorities for the Aboriginal LHINs leads network for 2015-16 include:
o Indigenous Cultural Competency and education;
o building community partnerships; and
o access to primary care and population health.
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
Four sub-groups were created to build action items for each of the priority areas. The Aboriginal Health Consultant
was tasked to lead the Indigenous Cultural Competency and education sub-group.
4. Demonstrate System Leadership
4.1 Population Health

Diversity and Health Equity – The Central West LHIN staff continues to work with Colour of Poverty – Colour of
Change (COP-COC) to lead and implement the piloting of Socio-demographic Data Collection at pilot HSPs over
this next fiscal year. Currently Socio-demographic Data Collection training is being led over the summer with data
collection occurring during the fall and winter months. By the end of this fiscal year, pilot organizations will provide
a report on the success and lessons of this type of data collection to inform the expansion of this work in the Central
West LHIN. The intention is to collect this information and utilize the data to improve access for populations that
should otherwise be utilizing the services. Such a project has a high potential to link neighbourhood demographics
to the current access and utilization of services in the health care system further informing organizational and system
level program investments and expansion.

As stated in the LHIN’s Annual Business Plan, staff will begin the process of gathering perspectives and research
on the development of the Central West LHIN’s Health Equity Charter. A local charter in alignment with provincial
and local cross sector partners will highlight the importance of this work to improve equitable access to all populations
in the LHIN. Charters developed by the Community Health Centres (CHCs) and the Regional Diversity Roundtable
(RDR) along with oversight and advice from members of the LHIN’s Diversity and Health Equity Core Action Group
will inform the development of the Central West LHIN Health Equity Charter.
4.2 Dementia Strategy

LHINs are awaiting the roll out of the next MOHLTC discussion document.
4.3 Build on the Momentum

Chronic Disease Prevention and Management Initiative - The LHIN Aboriginal Health Consultant presented at
the June 8th Chronic Disease Prevention and Management Core Action Group regarding an opportunity for HSPs
to participate in an on-line “Indigenous Cultural Competency” training program.

Information was shared by members regarding the priorities and activities in their 2016/17 work plans. Seniors and
the pre-diabetes patient populations were identified as priorities.
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5. Operational Excellence
5.1 Service Accountability Agreements Update

Previously, hospital agreements (HSAAs) were extended by three months from April 1st to June 30th, 2016, in
anticipation that a new HSAA would be ready for local implementation. At this point, the OHA is not prepared to
approve the simple HSAA, prior to the implementation of the Multi-Purpose HSAA.

The Multi-Purpose HSAA template is very important to the OHA. It is the prospect of a Multi-Purpose HSAA template
that has motivated the OHA to actively negotiate the new simple HSAA. The development of the Multi-Purpose
HSAA template is a complex process which requires significant consultation with the LHIN SAA leads and with the
OHA. The Steering Committee remains committed to finalizing this template as soon as reasonably possible.

In order to allow time to complete this work, the HSAA Steering Committee has advised LHINs across the Province
to further extend their current agreements to March 31st, 2017. The Central West LHIN has followed this advice and
has successfully extended its current H-SAAs to March 31st, 2017, by amending agreement.
6. Select CEO Updates
6.1 Provincial Aboriginal Planning Meeting

On May 17th and 18th I attended the Provincial Aboriginal Planning Meeting along with the Aboriginal Leads and the
LHIN CEOs in Grand Bend. The purpose of the session is to establish provincial priorities across the 14 LHINs.
6.2 e-Health Investment and Sustainment Board Meeting

A meeting was held on May 20th. Recent agenda items included:
o Developing a “Retail” Version of the Strategy
o eHealth Governance: implementing the Clinician eHealth Council & Community Care eHealth Committee
6.3 LHIN Leadership Council Meeting

The Leadership Council met on June 2nd. Agenda items included
o Priorities for Dialogue on Patients First Discussion Document
o Update from Chairs on the local status of governance structure and engagements related to Patients First
o Update on Patients First Discussion Document – provided by Dr. Bob Bell
6.4 LHIN CEO Council Meeting

The CEO Council met on June 2nd. The CEO Council had their regular business meeting following the Leadership
Councils.
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6.5 MOHLTC Executive Leadership Team and LHIN CEOs Joint Meeting

On June 7th and 8th I participated in a two-day Executive Leadership team meeting. Discussion items included:
o Update on Northern Investment Rollout
o ALC Update
o Urgent Priorities Funding Guidelines
o LHN Renewal Discussion
o Walk-through of Bill 201: The Patients First Act, 2016
o Patient Engagement
6.6 Health Service Provider Site Visits

Consistent with my Objectives I have continued the process of meeting with individual HSPs to understand current
challenges and opportunities. Recently I have met with the following HSPs:
o Richview Community Care – June 1st
o Malton Village – June 14th
o Punjabi Community Health Services –June 15th
o Wellfort Community Health Services – June 16th
6.7 Digital Health Steward Executive Committee

This Committee had their first meeting on June 3rd. The role and purpose of the committee is:
o Continued provincial Telehomecare support
o New e-Models of Care oversight (eMC3)
o Digital Health stewardship
7. On the Horizon
7.1 e-Health Steering Committee Meeting

The next meeting of the Committee is scheduled for June 15th.
7.2 KPMG Event – Value Optimization

I have been invited to attend this event taking place on June 16th.
7.3 MSAA Advisory Committee Meeting

The next meeting is scheduled to take place on June 17th.
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7.4 Rotman Day

June 22nd is scheduled for presentations by the participants and certificates will be awarded at this event.
7.5 Health Service Provider Site Visits

The following site visits are booked and will conclude site visits for this year:
o Peel Senior Link – June 20th
o Supportive Housing in Peel – June 20th
o United Achievers Community Services – July 4th
8. Outstanding People
Margaret Paan, Director, Central West Palliative Care Network
A Registered Nurse by trade, Margaret is a passionate healthcare leader who joined the Central West Palliative Care Network
(CWPCN) from her role as Director, Patient Care Services at the Central West Community Care Access Centre (CCAC), a
role which she held since 2009. During that time, Margaret was responsible for various portfolios including palliative and endof -life care.
Margaret Paan has worked in health care for almost 20 years in a variety of roles and sectors including acute care, outpatient,
government and community care.
Margaret holds a Bachelor of Science in Nursing from Ryerson Polytechnic University, a Masters of Nursing Administration
from the University of Toronto, has completed the Central West Advanced Health System Leadership Program at the
University of Toronto’s Rotman School of Management and most recently completed the IDEAS Advanced Learning Program
at the University of Toronto.
Among her many notable accomplishments, Margaret led the Central West CCAC Neighbourhood Transformation Project
which included a redesign of patient care service teams into sub-LHIN geographies and aligned all Care Coordinators to
Primary Care across the region. Margaret’s involvement in supporting the integration and development of Central West and
Mississauga Halton CCAC Palliative Care Teams and services helped to promote health equity and consistency of care for
clients, families and broader communities at large. As Lead for the Central West Palliative Early Identification Project, Margaret
helped to ensure palliative patients remained at the centre of care, identifying them early in their palliative journeys so as to
improve their access to and coordination of care, as well as quality and length of life.
Margaret is also a blessed and busy mother of 4 and enjoys living in the beautiful rural area of Dufferin.
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BOARD OF DIRECTORS' MEETING - WED., JUNE 22, 2016 - BOARD EDUCATION / GENERATIVE DIALOGUE
1ST SESSION, 41ST LEGISLATURE, ONTARIO
65 ELIZABETH II, 2016
1re SESSION, 41e LÉGISLATURE, ONTARIO
65 ELIZABETH II, 2016
Bill 210
Projet de loi 210
An Act to amend various Acts
in the interest of patient-centred care
Loi modifiant diverses lois
dans l’intérêt des soins
axés sur les patients
The Hon. E. Hoskins
L’honorable E. Hoskins
Minister of Health and Long-Term Care
Ministre de la Santé et des Soins de longue durée
Government Bill
Projet de loi du gouvernement
1st Reading
1re lecture
June 2, 2016
2nd Reading
2e lecture
3rd Reading
3e lecture
Royal Assent
Sanction royale
2 juin 2016
Imprimé par l’Assemblée législative
de l’Ontario
Printed by the Legislative Assembly
of Ontario
67
EXPLANATORY NOTE
NOTE EXPLICATIVE
The Bill amends the Local Health System Integration Act, 2006
and makes related amendments to several other Acts. The major
elements of the Bill are described below.
Le projet de loi modifie la Loi de 2006 sur l’intégration du système de santé local et apporte des modifications connexes à
plusieurs autres lois. Les éléments principaux du projet de loi
sont exposés ci-dessous.
Local Health System Integration Act, 2006
Loi de 2006 sur l’intégration du système de santé local
Community care access corporations (CCACs) are removed
from the definition of a “health service provider”. Several new
entities are added.
Les sociétés d’accès aux soins communautaires sont supprimées
de la définition de «fournisseur de services de santé». Plusieurs
nouvelles entités y sont ajoutées.
The Lieutenant Governor in Council is given the power to
change the geographic area of local health integration networks
by regulation.
Le lieutenant-gouverneur en conseil est investi du pouvoir de
modifier, par règlement, la zone géographique que servent les
réseaux locaux d’intégration des services de santé.
New subsection 4 (5) specifies that subsection 1 (4) of the Labour Relations Act, 1995 does not apply to local health integration networks.
Le nouveau paragraphe 4 (5) précise que le paragraphe 1 (4) de
la Loi de 1995 sur les relations de travail ne s’applique pas aux
réseaux locaux d’intégration des services de santé.
The objects of local health integration networks are modified.
Several amendments are made to the size of the board of directors of these networks and to the term of members of the board
of directors.
La mission des réseaux locaux d’intégration des services de
santé est modifiée. Plusieurs modifications sont apportées à la
taille du conseil d’administration de ces réseaux et au mandat de
leurs membres.
The boards of directors of local health integration networks are
provided with new by-law making authorities, including the
ability to appoint officers and delegate certain powers to other
persons.
Le conseil d’administration des réseaux locaux d’intégration des
services de santé est investi de nouveaux pouvoirs en matière
d’adoption de règlements administratifs, notamment le pouvoir
de nommer des dirigeants et de déléguer certains pouvoirs à
d’autres personnes.
New section 11.1 gives the Minister of Health and Long-Term
Care the power to issue operational or policy directives to local
health integration networks. Local health integration networks
must comply with these.
Le nouvel article 11.1 confère au ministre de la Santé et des
Soins de longue durée le pouvoir de donner des directives opérationnelles ou en matière de politique aux réseaux locaux
d’intégration des services de santé. Les réseaux doivent se conformer à ces directives.
New section 11.2 gives the Minister the power to issue provincial standards for the provision of health services. Local health
integration networks and health service providers must comply
with these.
Le nouvel article 11.2 confère au ministre le pouvoir d’établir
des normes provinciales relativement à la prestation de services
de santé. Les réseaux locaux d’intégration des services de santé
et les fournisseurs de services de santé doivent se conformer à
ces normes.
New section 12.1 gives the Minister the power to appoint investigators to investigate local health integration networks. New
section 12.2 allows the Lieutenant Governor in Council to appoint a supervisor for local health integration networks, on the
recommendation of the Minister, if the Lieutenant Governor in
Council considers it to be in the public interest to do so.
Le nouvel article 12.1 confère au ministre le pouvoir de nommer
des personnes chargées d’enquêter sur les réseaux locaux
d’intégration des services de santé. Le nouvel article 12.2 permet au lieutenant-gouverneur en conseil, sur la recommandation
du ministre et s’il estime que l’intérêt public le justifie, de nommer un superviseur pour les réseaux locaux d’intégration des
services de santé.
Local health integration networks are required to establish geographic sub-regions in their local health system for the purposes
of planning, funding and service integration. They must develop
strategic directions and plans for these sub-regions in their integrated health service plan.
Les réseaux locaux d’intégration des services de santé sont tenus
de créer des sous-zones géographiques dans leur système de
santé local pour la planification, le financement et l’intégration
des services. Ils doivent élaborer des orientations et des plans
stratégiques pour ces sous-zones dans leur plan de services de
santé intégrés.
Local health integration networks are required to establish one
or more patient and family advisory committees. The establishment of a health professionals advisory committee becomes
optional.
Les réseaux locaux d’intégration des services de santé sont tenus
de créer un ou plusieurs comités consultatifs patients-familles.
La création de comités consultatifs de professionnels de la santé
devient facultative.
Local health integration networks are given the ability to provide funding to health service providers in respect of services
provided in or for the geographic area of another network.
Les réseaux locaux d’intégration des services de santé sont investis du pouvoir d’accorder un financement aux fournisseurs de
services de santé à l’égard des services fournis dans la zone
géographique que sert un autre réseau ou pour cette zone.
New procedures and requirements are provided for service accountability agreements. The provision about local health integration networks not being allowed to enter into agreements or
other arrangements that restrict or prevent an individual from
receiving services based on the geographic area in which the
individual resides is re-enacted in a new section.
De nouvelles modalités et exigences sont prévues en ce qui concerne les ententes de responsabilisation en matière de services.
La disposition selon laquelle les réseaux locaux d’intégration
des services de santé ne doivent conclure aucune entente ni aucun autre arrangement ayant pour effet d’empêcher un particulier de recevoir des services en fonction de la zone géographique
où il réside, ou d’imposer des restrictions à cet égard, est réédictée dans un nouvel article.
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New section 20.2 allows local health integration networks to
issue operational or policy directives to a health provider to
which it provides funding. The health service provider must
comply with these.
Le nouvel article 20.2 permet aux réseaux locaux d’intégration
des services de santé de donner des directives opérationnelles ou
en matière de politique à un fournisseur de services de santé à
qui il accorde un financement. Le fournisseur de services de
santé doit se conformer à ces directives.
Local health integration networks are given the power to engage
in or permit operational reviews or peer reviews of a health provider’s activities.
Les réseaux locaux d’intégration des services de santé sont investis du pouvoir de procéder à un examen de gestion ou à un
examen par des pairs des activités d’un fournisseur de services
de santé ou d’autoriser de tels examens.
Local health integration networks are given the power to appoint
investigators to investigate certain health service providers that
receive funding from the network. The local health integration
network may appoint a health service provider supervisor to
exercise the powers of the governing body of certain health service providers if it considers it to be appropriate to do so in the
public interest.
Les réseaux locaux d’intégration des services de santé sont investis du pouvoir de nommer des personnes chargées d’enquêter
sur certains fournisseurs de services de santé qui reçoivent un
financement de leur part. Les réseaux peuvent, s’ils estiment que
l’intérêt public le justifie, nommer un superviseur pour certains
fournisseurs de services de santé chargé d’exercer les pouvoirs
de leur corps dirigeant.
Section 27 is amended to revise and update the local health integration networks’ integration power.
L’article 27 est modifié pour réviser et mettre à jour le pouvoir
d’intégration des réseaux locaux d’intégration des services de
santé.
New Part V.1 is added to the Act. New subsection 34.2 (1) provides the Minister with the ability to transfer the assets, liabilities, rights, obligations and employees of a community care
access corporation to the local health integration network that
has the same geographic area as the CCAC. Various rules regarding these transfers are set out.
La nouvelle partie V.1 est ajoutée à la Loi. Le nouveau paragraphe 34.2 (1) confère au ministre le pouvoir de transférer les
éléments d’actif, éléments de passif, droits et obligations d’une
société d’accès aux soins communautaires au réseau local
d’intégration des services de santé qui sert la même zone géographique que la société. Le ministre dispose aussi du pouvoir
de muter les employés de la société à un tel réseau. Diverses
règles relatives à ces transferts et mutations sont énoncées.
Employees transferred under an order become employees of the
local health integration network affected by the order.
Les employés mutés par suite d’un tel arrêté deviennent les employés du réseau local d’intégration des services de santé visé
par l’arrêté.
The Minister is also given the power to make an order to dissolve a CCAC that is affected by an order under subsection 34.2
(1). The legal effect of this order is set out.
Le ministre est également investi du pouvoir de prendre un arrêté pour dissoudre une société d’accès aux soins communautaires
visée par un arrêté pris en vertu du paragraphe 34.2 (1). L’effet
juridique de cet arrêté est énoncé.
Guidelines are provided to specify certain factors that the Lieutenant Governor in Council or the Minister may consider when
making a decision in the public interest under the Act.
Des lignes directrices sont prévues pour préciser certains facteurs que le lieutenant-gouverneur en conseil ou le ministre peut
prendre en considération lorsqu’il prend une décision dans
l’intérêt public dans le cadre de la Loi.
No proceeding for damages, with certain exceptions, may be
commenced against the Crown, the Minister, local health integration networks, members, directors or officers of local health
integration networks, investigators, supervisors, and any person
employed by the Crown, the Minister or a local health integration network with respect to certain actions or omissions under
the Act. This does not prevent a claim for compensation with
respect to the delivery of services by or arranged by a local
health integration network.
Sont irrecevables les instances en dommages-intérêts, sauf certaines exceptions, qui sont introduites contre la Couronne, le
ministre, les réseaux locaux d’intégration des services de santé
ou leurs membres, administrateurs ou dirigeants, les enquêteurs,
les superviseurs et toute personne employée par la Couronne, le
ministre ou un réseau pour un acte ou un manquement visé par
la Loi. La disposition n’a pas pour effet d’empêcher la présentation d’une demande d’indemnisation à l’égard de la prestation
des services fournis ou organisés par un réseau local
d’intégration des services de santé.
The Lieutenant Governor in Council is given the power to make
regulations requiring prescribed persons and entities to provide
certain information and reports to local health integration networks.
Le lieutenant-gouverneur en conseil est investi du pouvoir
d’exiger, par règlement, que des personnes et entités prescrites
fournissent certains renseignements et rapports aux réseaux
locaux d’intégration des services de santé.
The Lieutenant Governor in Council is given the power to incorporate a corporation without share capital to provide shared
services to local health integration networks and others. The
Minister is given the power to make an order transferring the
assets, liabilities, rights, obligations and employees from the
Ontario Association of Community Care Access Centres to this
corporation. Various rules regarding these transfers are set out.
Le lieutenant-gouverneur en conseil est investi du pouvoir de
constituer une personne morale sans capital-actions pour fournir
des services partagés aux réseaux locaux d’intégration des services de santé et à d’autres entités. Le ministre, quant à lui, est
investi du pouvoir de transférer, par arrêté, les éléments d’actif,
éléments de passif, droits et obligations de l’Ontario Association
of Community Care Access Centres à cette personne morale. Il
dispose aussi du pouvoir de muter les employés de l’Association
à la personne morale. Diverses règles régissant ces transferts
sont énoncées.
Broader Public Sector Accountability Act, 2010
Loi de 2010 sur la responsabilisation du secteur parapublic
Several amendments are made to remove references to CCACs.
Plusieurs modifications sont apportées à cette loi pour supprimer
les mentions des sociétés d’accès aux soins communautaires.
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Broader Public Sector Executive Compensation Act, 2014
Loi de 2014 sur la rémunération des cadres du secteur
parapublic
A reference to CCACs is removed.
Une mention des sociétés d’accès aux soins communautaires est
supprimée.
Commitment to the Future of Medicare Act, 2004
Loi de 2004 sur l’engagement d’assurer l’avenir de
l’assurance-santé
Part III of this Act is repealed.
La partie III de cette loi est abrogée.
Community Care Access Corporations Act, 2001
Loi de 2001 sur les sociétés d’accès aux soins communautaires
This Act is repealed.
Cette loi est abrogée.
Electronic Cigarettes Act, 2015
Loi de 2015 sur les cigarettes électroniques
The reference to CCACs in the definition of “home health-care
worker” is removed and replaced with a reference to local health
integration networks.
La mention de la société d’accès aux soins communautaires dans
la définition de «travailleur de la santé à domicile» est supprimée et remplacée par une mention d’un réseau local
Employment Standards Act, 2000
Loi de 2000 sur les normes d’emploi
Several consequential amendments are made. A provision dealing with assignment employees providing services under a contract with a CCAC is removed and replaced with a similar provision in respect of local health integration networks.
Plusieurs modifications corrélatives sont apportées. Une disposition traitant des employés ponctuels qui fournissent des services
aux termes d’un contrat conclu avec une société d’accès aux
soins communautaires est supprimée et remplacée par une disposition similaire à l’égard des réseaux locaux d’intégration des
services de santé.
Excellent Care for All Act, 2010
Loi de 2010 sur l’excellence des soins pour tous
The Council is given the ability to make clinical standards recommendations to the Minister. The Council is also given the
ability to receive, retain and use revenue outside of the Consolidated Revenue Fund. Other powers and duties with respect to
financial matters are set out. Changes are made to the purpose,
timing, and content of the Council’s reporting obligations.
Le Conseil est investi du pouvoir de formuler des recommandations sur les normes de soins cliniques au ministre. Il peut aussi
recevoir, conserver et utiliser les recettes qui ne font pas partie
du Trésor. D’autres pouvoirs et fonctions à l’égard des questions
financières sont énoncés. Des modifications sont apportées aux
objectifs, aux délais et au contenu des rapports que doit préparer
le Conseil.
The Crown and members, officers, employees and agents of the
Council and are protected from certain types of liability. This
does not protect the Council itself from liability.
La Couronne et les membres, dirigeants, employés et mandataires du Conseil sont dégagés de certains types de responsabilité, mais le Conseil demeure, quant à lui, responsable à l’égard de
certaines causes d’action.
The Patient Ombudsman is given oversight of complaints about
home and patient care, and other prescribed services, provided
by local health integration networks. Time limits for complaints
to the Patient Ombudsman may be set in regulations.
La supervision des plaintes relatives aux soins à domicile et aux
patients et à d’autres services prescrits fournis par les réseaux
locaux d’intégration des services de santé est confiée à
l’ombudsman des patients. Des délais pour la présentation des
plaintes auprès de l’ombudsman des patients peuvent être fixés
dans les règlements.
Health Insurance Act
Loi sur l’assurance-santé
The Minister is allowed to make local health integration networks an agent of the Minister for the purpose of certain funding
arrangements.
Le ministre peut constituer un réseau local d’intégration des
services de santé comme son mandataire pour ce qui est de certains arrangements en matière de financement.
Health Protection and Promotion Act
Loi sur la protection et la promotion de la santé
Medical officers of health are required to engage with their local
health integration networks. The Chief Medical Officer of
Health is given the power to issue directives to local health integration networks, rather than CCACs.
Les médecins-hygiénistes sont tenus de collaborer avec leur
réseau local d’intégration des services de santé. Le médecinhygiéniste en chef a le pouvoir de donner des directives aux
réseaux locaux d’intégration des services de santé plutôt qu’aux
sociétés d’accès aux soins communautaires.
Home Care and Community Services Act, 1994
Loi de 1994 sur les services de soins à domicile et les services
communautaires
Several amendments are made to permit the Minister to approve
and fund local health integration networks and provide the services currently provided by CCACs under the Act. Approved
agencies are permitted to charge fees for homemaking and
community support services, while local health integration networks are prohibited from charging such fees. A protection from
liability is set out.
Plusieurs modifications sont apportées pour permettre au ministre d’agréer et de financer les réseaux locaux d’intégration
des services de santé aux fins de la fourniture des services actuellement fournis par des sociétés d’accès aux soins communautaires dans le cadre de la Loi. Les organismes agréés peuvent
exiger le paiement de services d’aides familiales et de services
de soutien communautaire, alors que les réseaux locaux
d’intégration des services de santé ne peuvent exiger de tels
paiements. Une disposition sur l’immunité est énoncée.
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Ministry of Health and Long-Term Care Act
Loi sur le ministère de la Santé et des Soins de longue durée
The Minister is given the power to establish a Patient and Family Advisory Council.
Le ministre est investi du pouvoir de créer un conseil consultatif
patients-familles.
Ombudsman Act
Loi sur l’ombudsman
The Ombudsman Act is amended to provide that it does not apply to local health integration networks with respect to certain
matters that are to be overseen by the Patient Ombudsman.
La Loi sur l’ombudsman est modifiée afin qu’elle ne s’applique
pas aux réseaux locaux d’intégration des services de santé à
l’égard de certaines questions qui relèvent de l’ombudsman des
patients.
Personal Health Information Protection Act, 2004
Loi de 2004 sur la protection des renseignements personnels
sur la santé
CCACs are removed from the list of health information custodians.
Les sociétés d’accès aux soins communautaires sont supprimées
de la liste des dépositaires de renseignements sur la santé.
Poverty Reduction Act, 2009
Loi de 2009 sur la réduction de la pauvreté
A reference to CCACs is removed.
Une mention de la société d’accès aux soins communautaires est
supprimée.
Private Hospitals Act
Loi sur les hôpitaux privés
The Minister is given the power to issue operational or policy
directives to a licensee of a private hospital. These directives
must be complied with.
Le ministre est investi du pouvoir de donner des directives opérationnelles ou en matière de politique au titulaire de permis
d’exploitation d’un hôpital privé. Ces directives doivent être
respectées.
Public Hospitals Act
Loi sur les hôpitaux publics
The Minister must make certain reports on hospitals public.
Le ministre doit mettre certains rapports sur des hôpitaux à la
disposition du public.
The Minister is given the power to issue operational or policy
directives to the board of a hospital. These directives must be
complied with.
Le pouvoir de donner des directives opérationnelles ou en matière de politique au conseil d’un hôpital est conféré au ministre.
Ces directives doivent être respectées.
Public Sector Labour Relations Transition Act, 1997
Loi de 1997 sur les relations de travail liées à la transition
dans le secteur public
A reference to a local health integration network is added to the
definition of “health service integration”.
Une mention des réseaux locaux d’intégration des services de
santé est ajoutée à la définition de «intégration des services de
santé».
Retirement Homes Act, 2010
Loi de 2010 sur les maisons de retraite
A reference to CCACs is removed and a new reference to local
health integration networks is added.
supprimée et une nouvelle mention du réseau local d’intégration
des services de santé est ajoutée.
Smoke-Free Ontario Act
Loi favorisant un Ontario sans fumée
A reference to CCACs is removed and a new reference to local
health integration networks is added.
supprimée et une nouvelle mention du réseau local d’intégration
des services de santé est ajoutée.
iv
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72
Bill 210
2016
Projet de loi 210
2016
An Act to amend various Acts
in the interest of patient-centred care
Loi modifiant diverses lois
dans l’intérêt des soins
axés sur les patients
Her Majesty, by and with the advice and consent of the
Legislative Assembly of the Province of Ontario, enacts
as follows:
Sa Majesté, sur l’avis et avec le consentement de
l’Assemblée législative de la province de l’Ontario,
édicte :
LOCAL HEALTH SYSTEM INTEGRATION ACT, 2006
LOI DE 2006 SUR L’INTÉGRATION DU SYSTÈME
DE SANTÉ LOCAL
1. (1) Subsection 2 (1) of the Local Health System
Integration Act, 2006 is amended by adding the following definition:
1. (1) Le paragraphe 2 (1) de la Loi de 2006 sur
l’intégration du système de santé local est modifié par
adjonction de la définition suivante :
“medical officer of health” has the same meaning as in the
Health Protection and Promotion Act; (“médecinhygiéniste”)
«médecin-hygiéniste» S’entend au sens de la Loi sur la
protection et la promotion de la santé. («medical officer of health»)
(2) Paragraph 7 of the definition of “health service
provider” in subsection 2 (2) of the Act is repealed.
(2) La disposition 7 de la définition de «fournisseur
de services de santé» au paragraphe 2 (2) de la Loi est
abrogée.
(3) Paragraph 11 of the definition of “health service
provider” in subsection 2 (2) of the Act is repealed and
the following substituted:
(3) La disposition 11 de la définition de «fournisseur de services de santé» au paragraphe 2 (2) de la
Loi est abrogée et remplacée par ce qui suit :
11. A not for profit entity that operates a family health
team.
11. Une entité sans but lucratif qui encadre une équipe
de santé familiale.
12. A not for profit entity that operates a nursepractitioner-led clinic.
12. Une entité sans but lucratif qui fait fonctionner une
clinique dirigée par du personnel infirmier praticien.
13. A not for profit entity that operates an Aboriginal
health access centre.
13. Une entité sans but lucratif qui fait fonctionner un
centre d’accès aux services de santé pour les Autochtones.
14. A person or entity that provides primary care nursing services, maternal care or inter-professional
primary care programs and services.
14. Une personne ou entité qui fournit des services
infirmiers de soins primaires, des soins maternels
ou des programmes et services interprofessionnels
de soins primaires.
15. A not for profit entity that provides palliative care
services, including a hospice.
15. Une entité sans but lucratif qui fournit des services
de soins palliatifs et fait notamment fonctionner un
hospice.
16. A person or entity that provides physiotherapy services in a clinic setting that is not otherwise a
health service provider.
16. Une personne ou entité qui fournit des services de
physiothérapie dans une clinique qui n’est pas par
ailleurs un fournisseur de services de santé.
17. Any other person or entity or class of persons or
entities that is prescribed.
17. Toute autre personne ou entité prescrite ou toute
catégorie prescrite de personnes ou d’entités.
2. (1) Subsection 3 (4) of the Act is amended by
adding the following clause:
2. (1) Le paragraphe 3 (4) de la Loi est modifié par
adjonction de l’alinéa suivant :
(b.1) change the geographic area of one or more local
health integration networks;
b.1) modifier la zone géographique que servent un ou
plusieurs réseaux locaux d’intégration des services
de santé;
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PATIENTS FIRST ACT, 2016
(2) Clause 3 (4) (d) of the Act is amended by striking out the portion before subclause (i) and substituting the following:
(2) L’alinéa 3 (4) d) de la Loi est modifié par remplacement du passage qui précède le sous-alinéa (i) par
ce qui suit :
(d) do all things necessary to accomplish the amalgamation, dissolution, division or change of geographic area of one or more local health integration
networks made by a regulation under clause (a), (b)
or (b.1), including,
d) prendre les mesures nécessaires soit à la fusion, la
dissolution ou la division d’un ou de plusieurs réseaux locaux d’intégration des services de santé,
soit à la modification de leur zone géographique, à
laquelle il est procédé par règlement pris en vertu
de l’alinéa a), b) ou b.1) et, notamment :
.
.
.
.
.
.
.
.
.
.
3. Section 4 of the Act is amended by adding the
following subsection:
3. L’article 4 de la Loi est modifié par adjonction
du paragraphe suivant :
Non-application of single employer rule
Non-application de la règle d’un seul employeur
(5) Subsection 1 (4) of the Labour Relations Act, 1995
does not apply to a local health integration network.
(5) Le paragraphe 1 (4) de la Loi de 1995 sur les relations de travail ne s’applique pas à un réseau local
4. (1) Clause 5 (b) of the Act is repealed and the
following substituted:
4. (1) L’alinéa 5 b) de la Loi est abrogé et remplacé
par ce qui suit :
(b) to identify and plan for the health service needs of
the local health system, including needs regarding
physician resources, in accordance with provincial
plans and priorities and to make recommendations
to the Minister about that system, including capital
funding needs for it;
b) déterminer les besoins du système de santé local en
matière de services de santé, notamment les besoins concernant les effectifs médicaux, et prendre
des dispositions à leur égard conformément aux
plans et priorités provinciaux, et faire des recommandations au ministre au sujet du système, y
compris ses besoins en matière de financement
d’immobilisations;
(2) Section 5 of the Act is amended by adding the
following clause:
(2) L’article 5 de la Loi est modifié par adjonction
de l’alinéa suivant :
(e.1) to promote health equity, reduce health disparities
and inequities, and respect the diversity of communities in the planning, design, delivery and evaluation of services;
e.1) promouvoir l’équité et réduire les disparités et les
inégalités dans le domaine de la santé, et respecter
la diversité des collectivités dans le cadre de la planification, la conception, la prestation et
l’évaluation des services;
(3) Section 5 of the Act is amended by striking out
“and” at the end of clause (m) and by adding the following clauses:
des alinéas suivants :
(m.1) to provide health and related social services and
supplies and equipment for the care of persons in
home, community and other settings and to provide
goods and services to assist caregivers in the provision of care for such persons;
m.1) fournir des services de santé et des services sociaux
connexes ainsi que des fournitures et de
l’équipement pour soigner des personnes à domicile, dans la collectivité et ailleurs, et fournir des
biens et des services pour aider les fournisseurs de
soins à fournir des soins à ces personnes;
(m.2) to manage the placement of persons into long-term
care homes, supportive housing programs, chronic
care and rehabilitation beds in hospitals, and other
programs and places where community services are
provided under the Home Care and Community
Services Act, 1994;
m.2) gérer le placement de personnes dans des foyers de
soins de longue durée, des programmes de logement avec services de soutien, des lits de malades
chroniques et des lits de réadaptation d’hôpitaux, et
d’autres programmes et endroits où des services
communautaires sont fournis dans le cadre de la
Loi de 1994 sur les services de soins à domicile et
les services communautaires;
(m.3) to provide information to the public about, and
make referrals to, health and social services;
m.3) fournir des renseignements au public sur les services de santé et les services sociaux, et faire des
renvois vers ces services;
(m.4) to fund non-health services that are related to
health services that are funded by the Minister or a
local health integration network; and
m.4) financer des services non sanitaires qui sont liés
aux services de santé que finance le ministre ou un
réseau local d’intégration des services de santé;
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LOI DE 2016 DONNANT LA PRIORITÉ AUX PATIENTS
3
5. Paragraphs 6 and 7 of subsection 6 (3) of the Act
are repealed.
5. Les dispositions 6 et 7 du paragraphe 6 (3) de la
Loi sont abrogées.
6. (1) Subsection 7 (1) of the Act is repealed and the
6. (1) Le paragraphe 7 (1) de la Loi est abrogé et
remplacé par ce qui suit :
Board of directors
Conseil d’administration
(1) Each local health integration network shall consist
of no more than 12 members appointed by the Lieutenant
Governor in Council who shall form the board of directors of the network, except that the Lieutenant Governor
in Council may prescribe a higher number of members
that is not more than 14.
(1) Chaque réseau local d’intégration des services de
santé se compose d’au plus 12 membres que nomme le
lieutenant-gouverneur en conseil et qui en constituent le
conseil d’administration. Toutefois, le lieutenantgouverneur en conseil peut prescrire un nombre plus élevé
de membres, qui ne peut être supérieur à 14.
(2) Subsection 7 (2) of the Act is repealed and the
(2) Le paragraphe 7 (2) de la Loi est abrogé et remplacé par ce qui suit :
Term
Mandat
(2) Subject to subsection (3), the following provisions
apply respecting the term of members of the board of directors of a local health integration network:
(2) Sous réserve du paragraphe (3), les dispositions
suivantes s’appliquent à l’égard du mandat des membres
du conseil d’administration d’un réseau local
d’intégration des services de santé :
1. Each member shall hold office for a term of up to
three years at the pleasure of the Lieutenant Governor in Council and may be reappointed for any
number of terms of up to three years.
1. Chaque membre occupe son poste pour un mandat
d’au plus trois ans, dont la durée est laissée à la
discrétion du lieutenant-gouverneur en conseil. Son
mandat est renouvelable, une ou plusieurs fois,
pour des périodes d’au plus trois ans chacune.
2. Despite paragraph 1, no person may be a member
for more than six years in total.
2. Malgré la disposition 1, personne ne peut être
membre du conseil d’administration pendant plus
de six ans en tout.
3. Despite paragraph 2, a member who is designated
as chair under subsection (6) after serving at least
three years as a member may, despite anything else
in subsection (6), be appointed for one further term
of up to three years while designated as chair.
3. Malgré la disposition 2, le membre désigné comme
président en application du paragraphe (6), après
avoir siégé à titre de membre pendant au moins
trois ans, peut, malgré ce paragraphe, être nommé
pour un autre mandat d’au plus trois ans pendant sa
désignation comme président.
(3) Subsection 7 (4) of the Act is repealed.
(3) Le paragraphe 7 (4) de la Loi est abrogé.
(4) Le paragraphe 7 (10) de la Loi est abrogé et
Where no designation
Absence de désignation
(10) If the Lieutenant Governor in Council has not
designated a chair or a vice-chair of a network, the members of the board of directors may select a chair or vicechair from among their members to hold office as provided for by by-law, until such time as the Lieutenant Governor in Council makes a designation.
(10) Si le lieutenant-gouverneur en conseil n’a pas
désigné de président ou de vice-président d’un réseau
local d’intégration des services de santé, les membres du
conseil d’administration peuvent choisir, parmi eux, un
président ou un vice-président qui demeure en fonction,
comme le prévoit le règlement administratif, jusqu’à ce
que le lieutenant-gouverneur en conseil fasse une désignation.
7. (1) Subsection 8 (2) of the Act is repealed and the
7. (1) Le paragraphe 8 (2) de la Loi est abrogé et
By-laws and resolutions
Règlements administratifs et résolutions
(2) Subject to subsections (3) and (4), a board of directors may make by-laws and pass resolutions regulating its
proceedings and generally for the conduct and management of the affairs of the local health integration network
including establishing committees.
(2) Sous réserve des paragraphes (3) et (4), le conseil
d’administration peut adopter des règlements administratifs et des résolutions pour régir la conduite de ses délibérations et traiter, de façon générale, de la conduite et de la
gestion des affaires du réseau local d’intégration des services de santé, y compris créer des comités.
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Officers
Dirigeants
(2.1) Without limiting the generality of subsection (2),
a board of directors may make by-laws or pass resolutions
to appoint officers and assign to them such powers and
duties as the board considers appropriate.
(2.1) Sans préjudice de la portée générale du paragraphe (2), le conseil d’administration peut, par règlement
administratif ou résolution, nommer des dirigeants et leur
attribuer les pouvoirs et fonctions qu’il estime appropriés.
Delegation
Délégation
(2.2) A board of directors may delegate any of its powers or duties under this Act or any other Act to such person or persons as the board considers appropriate and may
impose conditions and restrictions with respect to the delegation.
(2.2) Le conseil d’administration peut déléguer les
pouvoirs ou les fonctions que lui attribue la présente loi
ou toute autre loi à la ou aux personnes qu’il juge compétentes et assortir cette délégation de conditions et de restrictions.
Restrictions on delegation
Restrictions : délégation
(2.3) Despite subsection (2.2), a board of directors may
not delegate any power under the following provisions of
this Act:
(2.3) Malgré le paragraphe (2.2), un conseil
d’administration ne peut déléguer aucun pouvoir prévu en
vertu des dispositions suivantes de la présente loi :
1. Subsection 20 (7).
1. Le paragraphe 20 (7).
2. Clause 25 (2) (a).
2. L’alinéa 25 (2) a).
3. Section 26.
3. L’article 26.
4. Section 27.
4. L’article 27.
(2) Subsection 8 (2.3) of the Act, as enacted by subsection (1), is amended by adding the following paragraphs:
(2) Le paragraphe 8 (2.3) de la Loi, tel qu’il est édicté par le paragraphe (1), est modifié par adjonction
des dispositions suivantes :
1.1 Section 20.2.
1.1 L’article 20.2.
1.2 Section 21.1.
1.3 Section 21.2.
(3) Subsection 8 (8) of the Act is repealed.
(3) Le paragraphe 8 (8) de la Loi est abrogé.
Educational or training sessions
Séances d’éducation ou de formation
(5.1) Despite subsection (4), a local health integration
network may exclude the public from a meeting if the
following conditions are both satisfied:
(5.1) Malgré le paragraphe (4), une réunion du réseau
local d’intégration des services de santé peut se tenir à
huis clos s’il est satisfait aux deux conditions suivantes :
1. The meeting is held for the purpose of educating or
training the members of the local health integration
network.
1. La réunion a pour but l’éducation ou la formation
des membres du réseau local d’intégration des services de santé.
2. At the meeting, no member discusses or otherwise
deals with any matter in a way that materially advances the decision-making of the local health integration network.
2. Lors de la réunion, aucun membre ne discute ou ne
traite autrement d’une question d’une manière qui
fait avancer de façon importante la prise de décision du réseau local d’intégration des services de
santé.
Medical officer of health engagement
Participation d’un médecin-hygiéniste
(3.1) A local health integration network shall ensure
that its chief executive officer engages with each medical
officer of health for any health unit located in whole or in
part within the geographic area of the network, or with the
medical officer of health’s delegate, on an ongoing basis
on issues related to local health system planning, funding
and service delivery.
(3.1) Les réseaux locaux d’intégration des services de
santé veillent à ce que leur chef de la direction participe,
de façon soutenue, avec chaque médecin-hygiéniste d’une
circonscription sanitaire située entièrement ou en partie
dans la zone géographique que sert chaque réseau, ou son
délégué, à l’étude de questions liées à la planification et
au financement du système de santé local et à la prestation
de services au sein du système.
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10. The Act is amended by adding the following
sections:
10. La Loi est modifiée par adjonction des articles
suivants :
Directives by Minister
Directives du ministre
11.1 (1) The Minister may issue operational or policy
directives to a local health integration network where the
Minister considers it to be in the public interest to do so.
11.1 (1) Le ministre peut donner des directives opérationnelles ou en matière de politique à un réseau local
d’intégration des services de santé s’il estime que l’intérêt
public le justifie.
Binding
Caractère obligatoire des directives
(2) A local health integration network shall comply
with every directive of the Minister.
(2) Le réseau local d’intégration des services de santé
doit se conformer aux directives du ministre.
General or particular
Portée
(3) An operational or policy directive of the Minister
may be general or particular in its application.
(3) La directive opérationnelle ou en matière de politique du ministre peut avoir une portée générale ou particulière.
Non-application of Legislation Act, 2006
Non-application de la Loi de 2006 sur la législation
(4) Part III (Regulations) of the Legislation Act, 2006
does not apply to operational or policy directives.
(4) La partie III (Règlements) de la Loi de 2006 sur la
législation ne s’applique pas aux directives opérationnelles ou en matière de politique.
Public availability
Mise à disposition du public
(5) The Minister shall make every directive under this
section available to the public.
(5) Le ministre met chaque directive donnée en vertu
du présent article à la disposition du public.
Law prevails
Primauté du droit
(6) For greater certainty, in the event of a conflict between a directive issued under this section and a provision
of any applicable Act or rule of any applicable law, the
Act or rule prevails.
(6) Il est entendu que, en cas d’incompatibilité entre
une directive donnée en vertu du présent article et une
disposition de toute loi applicable ou règle de toute loi
applicable, la loi ou la règle l’emporte.
Provincial standards
Normes provinciales
11.2 (1) The Minister may issue provincial standards
for the provision of health services that are provided or
arranged by local health integration networks or health
service providers where the Minister considers it to be in
the public interest to do so.
11.2 (1) S’il estime que l’intérêt public le justifie, le
ministre peut établir des normes provinciales relativement
à la prestation des services de santé que fournissent ou
qu’organisent les réseaux locaux d’intégration des services de santé ou les fournisseurs de services de santé.
Portée
(2) A standard of the Minister may be general or particular in its application.
(2) Une norme du ministre peut avoir une portée générale ou particulière.
Obligations re standards
Obligations : normes
(3) Every local health integration network and health
service provider to which a standard under this section is
directed shall comply with the standard.
santé et fournisseur de services de santé visé par une
norme établie en vertu du présent article doit s’y conformer.
does not apply to a standard under this section.
législation ne s’applique pas à une norme établie en vertu
du présent article.
Resolving differences over priorities
Règlement des différends concernant les priorités
(5) If a standard of a local health integration network
or a health service provider conflicts with a provincial
standard, the provincial standard prevails.
(5) En cas d’incompatibilité entre une norme d’un réseau local d’intégration des services de santé ou d’un
fournisseur de services de santé et une norme provinciale,
la norme provinciale l’emporte.
Same
Idem
(6) In the event of a conflict between a standard issued
under this section and a provision of any applicable Act or
(6) En cas d’incompatibilité entre une norme établie en
vertu du présent article et une disposition de toute loi ap-
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rule of any applicable law, the Act or rule prevails.
plicable ou règle de toute loi applicable, la loi ou la règle
l’emporte.
Public availability
(7) The Minister shall make every standard under this
(7) Le ministre met chaque norme établie en vertu du
présent article à la disposition du public.
sections:
suivants :
Investigators
Enquêteurs
12.1 (1) The Minister may appoint one or more investigators to investigate and report on the quality of the
management and administration of a local health integration network, or any other matter relating to a local health
integration network, where the Minister considers it in the
public interest to do so.
12.1 (1) Le ministre peut, s’il estime que l’intérêt public le justifie, nommer un ou plusieurs enquêteurs pour
enquêter et présenter un rapport sur la qualité de la gestion et de l’administration d’un réseau local d’intégration
des services de santé ou sur toute autre question relative à
un réseau.
Powers
Pouvoirs
(2) An investigator may, without a warrant and at reasonable times,
(2) L’enquêteur peut, sans mandat et à toute heure raisonnable :
(a) enter the premises of a local health integration
network; and
a) pénétrer dans les locaux d’un réseau local
d’intégration des services de santé;
(b) inspect the premises and the records relevant to the
investigation.
b) inspecter les locaux et les documents qui se rapportent à l’enquête.
Identification
Identification
(3) An investigator conducting an investigation shall
produce, on request, evidence of his or her appointment.
(3) L’enquêteur qui effectue une enquête produit, sur
demande, une attestation de sa nomination.
Powers of investigator
Pouvoirs de l’enquêteur
(4) An investigator conducting an investigation may,
(4) L’enquêteur qui effectue une enquête peut :
(a) require the production of records or anything else
that is relevant to the investigation, including
books of account, documents, bank accounts,
vouchers, correspondence and payroll records, records of staff hours worked and records of personal
health information;
a) exiger la production de dossiers ou d’autres choses
qui se rapportent à l’enquête, y compris les livres
de comptes, documents et comptes bancaires, les
pièces justificatives, la correspondance et les documents relatifs à la paie, aux heures de travail effectuées par le personnel et aux renseignements
personnels sur la santé;
(b) examine and copy any record or thing required
under clause (a);
b) examiner et tirer des copies des dossiers ou choses
exigés en vertu de l’alinéa a);
(c) upon giving a receipt and showing the evidence of
appointment, remove a record or anything else that
is relevant to the investigation for review or copying, as long as the review or copying is carried out
with reasonable dispatch and the record or thing is
promptly returned to the local health integration
network;
c) après avoir donné un récépissé à cet effet et produit
l’attestation de nomination, enlever des dossiers ou
d’autres choses qui se rapportent à l’enquête afin
de les examiner ou d’en tirer des copies, à condition de faire l’examen ou de tirer les copies avec
une diligence raisonnable et de retourner promptement les dossiers ou choses au réseau local
(d) in order to produce a record in readable form, use
data storage, information processing or retrieval
devices or systems that are normally used in carrying on business in the place; and
d) afin de produire un dossier sous une forme lisible,
recourir aux dispositifs ou systèmes de stockage,
de traitement ou de récupération des données qui
sont utilisés habituellement pour exercer les activités dans l’endroit;
(e) question a person on matters relevant to the investigation.
e) interroger des personnes sur des questions qui se
rapportent à l’enquête.
Obligation to produce and assist
Production de dossiers et aide obligatoires
(5) If an investigator requires the production of a record or anything else that is relevant to the investigation,
(5) Si un enquêteur exige la production de dossiers ou
d’autres choses qui se rapportent à l’enquête, la personne
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the person who has custody of the record or thing shall
produce it and, in the case of a record, shall on request
provide any assistance that is reasonably necessary to
interpret the record or to produce it in a readable form.
qui a la garde de ces dossiers ou choses les produit et,
dans le cas de dossiers, fournit, sur demande, l’aide qui
est raisonnablement nécessaire pour les interpréter ou les
produire sous une forme lisible.
Confidentiality
Confidentialité
(6) An investigator and his or her agents shall keep
confidential all information that comes to the investigator’s knowledge in the course of an investigation under
this Act and shall not communicate any information to
any other person except as required by law or except
where the communication is to the Minister or a person
employed in or performing services for the Ministry.
(6) Un enquêteur et ses mandataires préservent le caractère confidentiel de tous les renseignements venant à la
connaissance de l’enquêteur dans le cadre d’une enquête
effectuée en vertu de la présente loi et ne doivent en
communiquer aucun à qui que ce soit, sauf si la loi l’exige
ou si la communication est faite au ministre ou à une personne qui est employée dans le ministère ou qui fournit
des services pour le ministère.
Report
Rapport
(7) The investigator shall, upon completion of an investigation, make a report in writing to the Minister.
(7) L’enquêteur présente un rapport écrit au ministre à
l’issue de l’enquête.
Same
Idem
(8) The Minister shall cause a copy of the report of an
investigation to be delivered to the chair of the board of
directors of the local health integration network.
(8) Le ministre fait remettre une copie du rapport de
l’enquête au président du conseil d’administration du réseau local d’intégration des services de santé.
Public availability
(9) The Minister shall make every report of an investigation available to the public.
(9) Le ministre met chaque rapport d’enquête à la disposition du public.
Personal health information to be removed
Suppression des renseignements personnels sur la santé
(10) Before making a report available to the public
under subsection (9), the Minister shall ensure that all
personal health information in the report is redacted.
(10) Avant de mettre un rapport à la disposition du
public conformément au paragraphe (9), le ministre veille
à ce que tous les renseignements personnels sur la santé
qui y figurent soient retranchés.
Local health integration network supervisor
Superviseur du réseau local d’intégration des services de santé
12.2 (1) On the recommendation of the Minister, the
Lieutenant Governor in Council may appoint a person as
a local health integration network supervisor where the
Lieutenant Governor in Council considers it in the public
interest to do so.
12.2 (1) Sur la recommandation du ministre, le lieutenant-gouverneur en conseil peut, s’il estime que l’intérêt
public le justifie, nommer une personne superviseur d’un
réseau local d’intégration des services de santé.
Notice of appointment
Avis de nomination
(2) The Minister shall give the board of a local health
integration network at least 14 days notice before recommending to the Lieutenant Governor in Council that a
local health integration network supervisor be appointed.
(2) Le ministre donne au conseil d’un réseau local
d’intégration des services de santé un préavis d’au moins
14 jours avant de recommander au lieutenant-gouverneur
en conseil de nommer un superviseur pour le réseau.
Term of office
Mandat
(3) The appointment of a local health integration network supervisor is valid until terminated by order of the
Lieutenant Governor in Council.
(3) Le superviseur nommé pour un réseau local
d’intégration des services de santé reste en fonction
jusqu’à ce que le lieutenant-gouverneur en conseil mette
fin, par décret, à son mandat.
Powers of supervisor
Pouvoirs du superviseur
(4) Unless the appointment provides otherwise, a local
health integration network supervisor has the exclusive
right to exercise all of the powers of the board of the network and of the network and its officers.
(4) Sauf disposition contraire de l’acte de nomination,
le superviseur d’un réseau local d’intégration des services
de santé a le droit exclusif d’exercer tous les pouvoirs du
conseil du réseau, du réseau et de ses dirigeants.
Same
Idem
(5) The Lieutenant Governor in Council may specify
the powers and duties of a local health integration network supervisor appointed under this section and the
terms and conditions governing those powers and duties.
(5) Le lieutenant-gouverneur en conseil peut préciser
les pouvoirs et fonctions du superviseur d’un réseau local
d’intégration des services de santé nommé en vertu du
présent article ainsi que les conditions les régissant.
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Additional powers of supervisor
Pouvoirs supplémentaires du superviseur
(6) If, under the order of the Lieutenant Governor in
Council, the board of the network continues to have the
right to act with regard to any matters, any such act of the
board is valid only if approved in writing by the local
health integration network supervisor.
(6) Si, aux termes du décret du lieutenant-gouverneur
en conseil, le conseil du réseau local d’intégration des
services de santé continue d’avoir le droit d’agir à l’égard
d’une question quelconque, ses actions ne sont valides
que si elles sont approuvées par écrit par le superviseur du
réseau.
Right of access
Droit d’accès
(7) A local health integration network supervisor appointed for a local health integration network has the
same rights as the board and the chief executive officer of
the network in respect of the documents, records and information of the board and the network.
(7) Le superviseur nommé pour un réseau local
d’intégration des services de santé possède les mêmes
droits que le conseil et le chef de la direction du réseau en
ce qui concerne les documents, dossiers et renseignements
du conseil et du réseau.
Minister’s directions
(8) The Minister may issue directions to a local health
integration network supervisor with regard to any matter
within the jurisdiction of the supervisor.
(8) Le ministre peut donner au superviseur d’un réseau
local d’intégration des services de santé des directives sur
toute question relevant de la compétence du superviseur.
Directions to be followed
Obligation de suivre les directives
(9) A local health integration network supervisor shall
carry out every direction of the Minister.
(9) Le superviseur d’un réseau local d’intégration des
services de santé doit exécuter les directives du ministre.
Report to Minister
Rapport présenté au ministre
(10) A local health integration network supervisor shall
report to the Minister as required by the Minister.
(10) Le superviseur d’un réseau local d’intégration des
services de santé présente un rapport au ministre à la demande de ce dernier.
Public availability
(11) The Minister shall make every report of a supervisor available to the public.
(11) Le ministre met chaque rapport du superviseur à
la disposition du public.
(12) Before making a report available to the public
under subsection (11), the Minister shall ensure that all
personal health information in the report is redacted.
public conformément au paragraphe (11), le ministre
veille à ce que tous les renseignements personnels sur la
santé qui y figurent soient retranchés.
section:
12. La Loi est modifiée par adjonction de l’article
suivant :
Sub-regions
Sous-zones
14.1 (1) Each local health system integration network
shall establish geographic sub-regions in its local health
system for the purposes of planning, funding and integrating services within those geographic sub-regions.
14.1 (1) Chaque réseau local d’intégration des services
de santé crée des sous-zones géographiques dans son système de santé local pour les besoins de la planification, du
financement et de l’intégration des services dans ces souszones.
Maps
Carte
(2) Each network shall make a map of the sub-regions
available to the public.
santé met une carte des sous-zones à la disposition du
public.
13. (1) Section 15 of the Act is amended by adding
the following subsection:
13. (1) L’article 15 de la Loi est modifié par adjonction du paragraphe suivant :
Sub-regions, direction
Sous-zones : orientation
(2.1) The integrated health service plan shall include
strategic directions and plans for the geographic subregions of a local health system in order to achieve the
purposes of this Act.
(2.1) Le plan de services de santé intégrés comprend
une orientation et des plans stratégiques pour les souszones géographiques d’un système de santé local afin de
réaliser l’objet de la présente loi.
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Consultations
Consultations
(4) A local health integration network shall engage and
seek advice from each board of health for any health unit
located in whole or in part within the geographic area of
the network in developing its integrated health service
plan.
fait participer chaque conseil de santé d’une circonscription sanitaire située entièrement ou en partie dans la zone
géographique qu’il sert à l’élaboration de son plan de services de santé intégrés et le consulte à cet égard.
14. (1) Section 16 of the Act is amended by adding
the following subsection:
14. (1) L’article 16 de la Loi est modifié par adjonction du paragraphe suivant :
Patient and family advisory committee
Comité consultatif patients-familles
(4.1) Each local health integration network shall establish one or more patient and family advisory committees.
(4.1) Chaque réseau local d’intégration des services de
santé crée un ou plusieurs comités consultatifs patientsfamilles.
(2) Subsection 16 (5) of the Act is amended by striking out “shall establish” and substituting “may establish”.
(2) Le paragraphe 16 (5) de la Loi est modifié par
remplacement de «crée» par «peut créer».
15. Part IV of the Act is amended by adding the
following section:
15. La partie IV de la Loi est modifiée par adjonction de l’article suivant :
“Personal health information”
Renseignements personnels sur la santé
16.1 In this Part,
16.1 La définition qui suit s’applique à la présente partie.
“personal health information” has the same meaning as in
section 4 of the Personal Health Information Protection Act, 2004, except that subsection 4 (3) of that Act
does not apply.
«renseignements personnels sur la santé» S’entend au
sens de l’article 4 de la Loi de 2004 sur la protection
des renseignements personnels sur la santé, sauf que le
paragraphe 4 (3) de cette loi ne s’applique pas.
16. Subsection 18 (4) of the Act is amended by striking out “as defined in subsection 31 (5) of the Commitment to the Future of Medicare Act, 2004”.
16. Le paragraphe 18 (4) de la Loi est modifié par
suppression de «au sens du paragraphe 31 (5) de la Loi
de 2004 sur l’engagement d’assurer l’avenir de
l’assurance-santé».
17. Subsection 19 (1) of the Act is repealed and the
17. Le paragraphe 19 (1) de la Loi est abrogé et
Funding of health service providers
Financement des fournisseurs de services de santé
(1) A local health integration network may provide
funding,
(1) Un réseau local d’intégration des services de santé
peut accorder un financement :
(a) to a health service provider in respect of services
that the service provider provides in or for the geographic area of the network; and
a) à un fournisseur de services de santé à l’égard des
services que celui-ci fournit dans la zone géographique que sert le réseau ou pour cette zone;
(b) to a health service provider in respect of services
that the service provider provides in or for the geographic area of another network.
b) à un fournisseur de services de santé à l’égard des
services que celui-ci fournit dans la zone géographique que sert un autre réseau ou pour cette zone.
18. Section 20 of the Act is repealed and the following substituted:
18. L’article 20 de la Loi est abrogé et remplacé par
ce qui suit :
Service accountability agreement
Entente de responsabilisation en matière de services
20. (1) Where a local health integration network proposes to provide funding to a health service provider or
amend a service accountability agreement with a health
service provider, the network and the provider shall enter
into a service accountability agreement or amend such an
agreement in accordance with this section.
20. (1) Si un réseau local d’intégration des services de
santé se propose d’accorder un financement à un fournisseur de services de santé ou de modifier une entente de
responsabilisation en matière de services conclue avec un
fournisseur, le réseau et le fournisseur concluent une entente de responsabilisation en matière de services ou modifient une telle entente conformément au présent article.
Notification required
Avis requis
(2) A local health integration network shall notify a
health service provider that it intends to enter into a service accountability agreement with the provider or that it
avise le fournisseur de services de santé qu’il a l’intention
de conclure une entente de responsabilisation en matière
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seeks to amend such an agreement.
de services avec lui ou qu’il demande la modification
d’une telle entente.
Negotiation
Négociation
(3) After being notified under subsection (2), the parties shall seek to negotiate the terms and conditions of the
service accountability agreement or the amendment.
(3) Après avoir reçu l’avis prévu au paragraphe (2), les
parties cherchent à négocier les conditions de l’entente de
responsabilisation en matière de services ou de la modification.
Where agreement cannot be negotiated
Cas où aucune négociation n’a eu lieu
(4) If the parties have not negotiated a service accountability agreement or an amendment within 90 days of the
notice under subsection (2), then, any time after the 90th
day, the network may deliver a notice of an offer to the
provider setting out the terms and conditions of the proposed agreement or amendment, and the network shall
notify the Minister of that offer.
(4) Si les parties n’ont pas négocié d’entente de responsabilisation en matière de services ou de modification
à une telle entente dans les 90 jours de l’avis prévu au
paragraphe (2), le réseau peut, après le 90 e jour, remettre
un avis d’offre au fournisseur dans lequel il énonce les
conditions de l’entente proposée ou de la modification
proposée. Le réseau avise le ministre de cette offre.
Deemed acceptance
Offre réputée acceptée
(5) If the provider does not deliver a rejection notice
within 30 days of receiving the notice of an offer under
subsection (4), then the notice of offer shall be deemed to
be the service accountability agreement between the network and the provider or an amendment to such an
agreement, as the case may be, and the network and the
provider shall comply with that agreement.
(5) Si le fournisseur ne remet pas un avis de rejet de
l’offre dans les 30 jours de la réception de l’avis d’offre
prévu au paragraphe (4), cet avis est réputé être soit
l’entente de responsabilisation en matière de services
conclue entre le réseau et le fournisseur, soit une modification à une telle entente. Le réseau et le fournisseur doivent alors se conformer à l’entente.
Rejection
Rejet
(6) The provider may reject any offer referred to in
subsection (4) by providing a notice to the network and
the Minister within 30 days of receiving the notice of offer from the network.
(6) Le fournisseur peut rejeter toute offre visée au paragraphe (4) en remettant un avis à cet effet au réseau et
au ministre dans les 30 jours de la réception de l’avis
d’offre de la part du réseau.
Setting the terms
Fixation des conditions
(7) If the provider delivers a notice under subsection
(6),
(7) Si le fournisseur remet l’avis prévu au paragraphe
(6) :
(a) the local health integration network may at any
time give notice to the provider and the Minister
that it intends to set the terms and conditions of the
service accountability agreement or amendment to
such an agreement, as the case may be; and
a) le réseau local d’intégration des services de santé
peut, en tout temps, donner au fournisseur et au
ministre un avis les informant qu’il a l’intention de
fixer les conditions de l’entente de responsabilisation en matière de services ou de la modification à
une telle entente, selon le cas;
(b) at any time more than 30 days after giving notice
under clause (a), if the network and the provider
have not negotiated a service accountability
agreement or amendment, as the case may be, the
network may, if it considers it in the public interest
to do so, set the terms and conditions of the service
accountability agreement or amendment, and the
network and the provider shall comply with those
terms and conditions.
b) en tout temps plus de 30 jours après avoir donné
l’avis prévu à l’alinéa a) et si le réseau et lui n’ont
pas négocié d’entente de responsabilisation en matière de services ou de modification à une telle entente, selon le cas, le réseau peut, s’il estime que
l’intérêt public le justifie, fixer les conditions de
l’entente ou de la modification, auquel cas le réseau et le fournisseur doivent s’y conformer.
Saving
Exception
(8) Nothing in subsection (4), (5), (6) or (7) prevents
the network and the provider from negotiating a service
accountability agreement during the time period set out in
subsection (4) or (6) or from agreeing to amend a service
accountability agreement that is deemed under subsection
(5).
(8) Le paragraphe (4), (5), (6) ou (7) n’a pas pour effet
d’empêcher le réseau et le fournisseur de négocier une
entente de responsabilisation en matière de services pendant le délai prévu au paragraphe (4) ou (6) ou de convenir de modifier l’entente réputée conclue en application
du paragraphe (5).
No restriction on patient mobility
Aucune restriction à l’égard de la mobilité des malades
20.1 (1) A local health integration network shall not
enter into any agreement or other arrangement, including
20.1 (1) Les réseaux locaux d’intégration des services
de santé ne doivent conclure aucune entente ni aucun
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issuing an integration decision under Part V of this Act,
that restricts or prevents an individual from receiving services based on the geographic area in which the individual resides.
autre arrangement, y compris prendre une décision
d’intégration dans le cadre de la partie V de la présente
loi, qui a pour effet d’empêcher un particulier de recevoir
des services en fonction de la zone géographique où il
réside ou d’imposer des restrictions à cet égard.
Geographic restrictions for homecare services
Restrictions géographiques pour les services de soins à domicile
(2) For greater certainty, subsection (1) applies to a
service accountability agreement in respect of funding
provided by a local health integration network for the
delivery of services by a health service provider under
section 20, but it does not apply to any agreement between a local health integration network and a service
provider under the Home Care and Community Services
Act, 1994 that requires the service provider to deliver services in the geographic area or a sub-region of the network.
(2) Il est entendu que le paragraphe (1) s’applique à
une entente de responsabilisation en matière de services à
l’égard d’un financement accordé par un réseau local
d’intégration des services de santé pour la prestation de
services par un fournisseur de services de santé en vertu
de l’article 20. Toutefois, il ne s’applique pas à une entente conclue entre un réseau et un fournisseur de services
dans le cadre de la Loi de 1994 sur les services de soins à
domicile et les services communautaires qui exige que le
fournisseur fournisse des services dans la zone ou la souszone géographique que sert le réseau.
section:
suivant :
Directives by local health integration networks
Directives des réseaux locaux d’intégration des services de santé
20.2 (1) A local health integration network may issue
operational or policy directives to a health service provider to which it provides funding where the network considers it to be in the public interest to do so.
20.2 (1) Un réseau local d’intégration des services de
santé peut donner des directives opérationnelles ou en
matière de politique à un fournisseur de services de santé
à qui il accorde un financement s’il estime que l’intérêt
public le justifie.
Exception
Exception
(2) Subsection (1) does not apply to a licensee within
the meaning of the Long-Term Care Homes Act, 2007.
(2) Le paragraphe (1) ne s’applique pas à un titulaire
de permis au sens de la Loi de 2007 sur les foyers de soins
de longue durée.
Binding
(3) A health service provider shall comply with every
directive of a local health integration network.
(3) Le fournisseur de services de santé doit se conformer aux directives du réseau local d’intégration des services de santé.
Portée
(4) An operational or policy directive of a local health
integration network may be general or particular in its
application.
(4) La directive opérationnelle ou en matière de politique du réseau local d’intégration des services de santé
peut avoir une portée générale ou particulière.
Law prevails
Primauté du droit
does not apply to the operational or policy directives.
Public availability
(7) A local health integration network shall make every
directive under this section available to the public.
met chaque directive donnée en vertu du présent article à
la disposition du public.
20. Section 21 of the Act is repealed and the following substituted:
20. L’article 21 de la Loi est abrogé et remplacé par
ce qui suit :
Audits, reviews, etc.
Vérifications et examens
21. A local health integration network may at any time
21. Un réseau local d’intégration des services de santé
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direct that a health service provider that receives funding
from the network,
peut en tout temps enjoindre à un fournisseur de services
de santé qui reçoit un financement de lui de faire ce qui
suit :
(a) engage or permit one or more auditors licensed
under the Public Accounting Act, 2004 to audit the
accounts and financial transactions of the service
provider; or
a) engager un ou plusieurs vérificateurs titulaires d’un
permis délivré en vertu de la Loi de 2004 sur
l’expertise comptable pour vérifier ses comptes et
ses opérations financières ou les y autoriser;
(b) engage in or permit an operational review or peer
review of the provider’s activities.
b) procéder à un examen de gestion ou à un examen
par des pairs de ses activités ou autoriser un tel
examen.
sections:
suivants :
Investigators
Enquêteurs
21.1 (1) A local health integration network may appoint one or more investigators to investigate and report
on the quality of the management of a health service provider, the quality of the care and treatment of persons by a
health service provider or any other matter relating to a
health service provider where the local health integration
network considers it to be in the public interest to do so.
21.1 (1) Un réseau local d’intégration des services de
santé peut, s’il estime que l’intérêt public le justifie,
nommer un ou plusieurs enquêteurs pour enquêter et présenter un rapport sur la qualité de la gestion d’un fournisseur de services de santé, la qualité des soins et des traitements fournis aux personnes par un fournisseur de services de santé, ou toute autre question relative à un fournisseur de services de santé.
Application
Champ d’application
(2) Subsection (1) applies to health service providers
that receive funding from the local health integration network but does not apply to a licensee within the meaning
of the Long-Term Care Homes Act, 2007.
(2) Le paragraphe (1) s’applique aux fournisseurs de
services de santé qui reçoivent un financement du réseau
local d’intégration des services de santé. Toutefois, il ne
s’applique pas à un titulaire de permis au sens de la Loi de
2007 sur les foyers de soins de longue durée.
Powers
Pouvoirs
(3) An investigator may, without a warrant and at reasonable times,
(a) enter the premises of a health service provider that
may be investigated under this section;
(3) L’enquêteur peut, sans mandat et à toute heure raisonnable :
a) pénétrer dans les locaux d’un fournisseur de services de santé pouvant faire l’objet d’une enquête
en vertu du présent article;
b) sous réserve du paragraphe (4), pénétrer dans tout
local où un fournisseur de services de santé fournit
des services;
c) inspecter les locaux et examiner les services qui y
sont fournis et les documents qui se rapportent à
l’enquête.
(b) subject to subsection (4), enter any premises where
a health service provider provides services; and
(c) inspect the premises, the services provided on the
premises and the records relevant to the investigation.
Dwellings
Logements
(4) No investigator shall enter a place that is being
used as a dwelling, except with the consent of the occupier.
(4) L’enquêteur ne doit pas pénétrer dans un lieu qui
sert de logement, sauf si l’occupant des lieux y consent.
Identification
Identification
(5) An investigator conducting an investigation shall
produce, on request, evidence of his or her appointment.
(5) L’enquêteur qui effectue une enquête produit, sur
demande, une attestation de sa nomination.
Powers of investigator conducting investigation
Pouvoirs de l’enquêteur
(6) An investigator conducting an investigation may,
(6) L’enquêteur qui effectue une enquête peut :
(a) require the production of records or anything else
that is relevant to the investigation, including
books of account, documents, bank accounts,
vouchers, correspondence and payroll records, records of staff hours worked and records of personal
health information;
a) exiger la production de dossiers ou d’autres choses
qui se rapportent à l’enquête, y compris les livres
de comptes, documents et comptes bancaires, les
pièces justificatives, la correspondance et les documents relatifs à la paie, aux heures de travail effectuées par le personnel et aux renseignements
personnels sur la santé;
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(b) examine and copy any record or thing required
under clause (a);
b) examiner et tirer des copies des dossiers ou des
choses exigés en vertu de l’alinéa a);
(c) upon giving a receipt and showing the evidence of
appointment, remove a record or anything else that
is relevant to the investigation for review or copying, as long as the review or copying is carried out
with reasonable dispatch and the record or thing is
promptly returned to the local health integration
network;
c) après avoir donné un récépissé à cet effet et produit
l’attestation de nomination, enlever des dossiers ou
d’autres choses qui se rapportent à l’enquête afin
de les examiner ou d’en tirer des copies, à condition de faire l’examen ou de tirer les copies avec
une diligence raisonnable et de retourner promptement les dossiers ou choses au réseau local
(d) in order to produce a record in readable form, use
data storage, information processing or retrieval
devices or systems that are normally used in carrying on business in the place; and
d) afin de produire un dossier sous une forme lisible,
recourir aux dispositifs ou systèmes de stockage,
de traitement ou de récupération des données qui
sont utilisés habituellement pour exercer les activités dans l’endroit;
(e) question a person on matters relevant to the investigation.
e) interroger des personnes sur des questions qui se
rapportent à l’enquête.
Obligation to produce and assist
Production de dossiers et aide obligatoires
(7) If an investigator requires the production of a record or anything else that is relevant to the investigation
under this section, the person who has custody of the record or thing shall produce it and, in the case of a record,
shall on request provide any assistance that is reasonably
necessary to interpret the record or to produce it in a readable form.
(7) Si un enquêteur exige la production de dossiers ou
d’autres choses qui se rapportent à l’enquête en vertu du
présent article, la personne qui a la garde de ces dossiers
ou choses les produit et, dans le cas de dossiers, fournit,
sur demande, l’aide qui est raisonnablement nécessaire
pour les interpréter ou les produire sous une forme lisible.
Confidentiality
Confidentialité
(8) An investigator and his or her agents shall keep
confidential all information that comes to the investigator’s knowledge in the course of an investigation under
this Act and shall not communicate any information to
any other person except as required by law or except
where the communication is to the local health integration
network or a person employed in or performing services
for the local health integration network.
(8) Un enquêteur et ses mandataires préservent le caractère confidentiel de tous les renseignements venant à la
connaissance de l’enquêteur dans le cadre d’une enquête
effectuée en vertu de la présente loi et ne doivent en
communiquer aucun à qui que ce soit, sauf si la loi l’exige
ou si la communication est faite au réseau local
d’intégration des services de santé ou à une personne qui
est employée dans le réseau ou qui fournit des services
pour le réseau.
Report of investigator
Rapport de l’enquêteur
(9) The investigator shall, upon completion of an investigation, make a report in writing to the local health
integration network.
(9) L’enquêteur présente un rapport écrit au réseau
local d’intégration des services de santé à l’issue de
l’enquête.
Report
Rapport
(10) The local health integration network shall cause a
copy of the report of an investigation to be delivered to
the health service provider.
fait remettre une copie du rapport d’enquête au fournisseur de services de santé.
Public availability
(11) The local health integration network shall make
every report of an investigation available to the public.
met chaque rapport d’enquête à la disposition du public.
(12) Before making a report public under subsection
(11), the local health integration network shall ensure that
all personal health information in the report is redacted.
public conformément au paragraphe (11), le réseau local
d’intégration des services de santé veille à ce que tous les
renseignements personnels sur la santé qui y figurent
soient retranchés.
Health service provider supervisor
Superviseur du fournisseur de services de santé
21.2 (1) A local health integration network may appoint a person as a health service provider supervisor of a
21.2 (1) Le réseau local d’intégration des services de
santé peut, s’il estime que l’intérêt public le justifie,
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health service provider to which it provides funding when
it considers it to be appropriate to do so in the public interest.
nommer une personne superviseur d’un fournisseur de
services de santé du fournisseur à qui il accorde un financement.
Certain providers excepted
Exception : certains fournisseurs
(2) This section does not apply with respect to a health
service provider that is,
(2) Le présent article ne s’applique pas à l’égard d’un
fournisseur de services de santé qui est :
(a) a person or entity that operates a hospital within the
meaning of the Public Hospitals Act or a private
hospital within the meaning of the Private Hospitals Act; or
a) une personne ou entité qui fait fonctionner un hôpital au sens de la Loi sur les hôpitaux publics ou qui
exploite un hôpital privé au sens de la Loi sur les
hôpitaux privés;
(b) a licensee within the meaning of the Long-Term
Care Homes Act, 2007.
b) un titulaire de permis au sens de la Loi de 2007 sur
les foyers de soins de longue durée.
Notice of appointment
Avis de nomination
(3) The local health integration network shall give the
governing body of the health service provider at least 14
days notice before appointing the supervisor.
donne au corps dirigeant du fournisseur de services de
santé un préavis d’au moins 14 jours avant de nommer un
superviseur.
Immediate appointment
Nomination immédiate
(4) Subsection (3) does not apply if there are not
enough members of the governing body to form a quorum.
(4) Le paragraphe (3) ne s’applique pas s’il n’y a pas
assez de membres du corps dirigeant pour constituer le
quorum.
Term of office
Mandat
(5) The appointment of a health service provider supervisor is valid until terminated by order of the network.
(5) Le superviseur nommé pour un fournisseur de services de santé reste en fonction jusqu’à ce que le réseau
mette fin, par ordre, à son mandat.
Powers of supervisor
Pouvoirs du superviseur
(6) Unless the appointment provides otherwise, a
health service provider supervisor has the exclusive right
to exercise all of the powers of the governing body of the
provider and its officers.
(6) Sauf disposition contraire de l’acte de nomination,
le superviseur d’un fournisseur de services de santé a le
droit exclusif d’exercer tous les pouvoirs du corps dirigeant du fournisseur et de ses dirigeants.
Same
Idem
(7) The local health integration network may specify
the powers and duties of a health service provider supervisor appointed under this section and the terms and conditions governing those powers and duties.
peut préciser les pouvoirs et fonctions du superviseur d’un
fournisseur de services de santé nommé en vertu du présent article ainsi que les conditions les régissant.
Additional powers of supervisor
Pouvoirs supplémentaires du superviseur
(8) If, under the order of the network, the governing
body continues to have the right to act with regard to any
matters, any such act of the body is valid only if approved
in writing by the health service provider supervisor.
(8) Si, aux termes de l’ordre du réseau, le corps dirigeant continue d’avoir le droit d’agir à l’égard d’une
question quelconque, ses actions ne sont valides que si
elles sont approuvées par écrit par le superviseur du fournisseur de services de santé.
Right of access
Droit d’accès
(9) A health service provider supervisor appointed for
a health service provider has the same rights as the governing body and the chief executive officer of the provider in respect of the documents, records and information of
the body and the provider.
(9) Le superviseur nommé pour un fournisseur de services de santé possède les mêmes droits que le corps dirigeant et le chef de la direction du fournisseur en ce qui
concerne les documents, dossiers et renseignements du
corps dirigeant et du fournisseur.
Reports
Rapport présenté au réseau
(10) A health service provider supervisor shall make a
report to the network as required by the network.
(10) Le superviseur d’un fournisseur de services de
santé présente un rapport au réseau local d’intégration des
services de santé à la demande de ce dernier.
Network’s directions
Directives du réseau
(11) The local health integration network may issue
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directions to a health service provider supervisor with
regard to any matter within the jurisdiction of the supervisor.
peut donner au superviseur d’un fournisseur de services
de santé des directives sur toute question relevant de la
compétence du superviseur.
Directions to be followed
Obligation de suivre les directives
(12) A health service provider supervisor shall carry
out every direction of the network.
(12) Le superviseur d’un fournisseur de services de
santé doit exécuter les directives du réseau local
Public availability
(13) The network shall make every report of a supervisor available to the public.
met chaque rapport du superviseur à la disposition du
public.
(14) Before making a report public under subsection
(13), the network shall ensure that all personal health information in the report is redacted.
public conformément au paragraphe (13), le réseau veille
à ce que tous les renseignements personnels sur la santé
qui y figurent soient retranchés.
22. (1) Subsection 22 (1) of the Act is amended by
striking out “as defined in subsection 31 (5) of the
Commitment to the Future of Medicare Act, 2004”.
22. (1) Le paragraphe 22 (1) de la Loi est modifié
par suppression de «au sens du paragraphe 31 (5) de
la Loi de 2004 sur l’engagement d’assurer l’avenir de
l’assurance-santé,».
(2) Subsection 22 (2) of the Act is amended by striking out,
suppression de :
(a) “as defined in subsection 31 (5) of the Commitment to the Future of Medicare Act, 2004”; and
a) «au sens du paragraphe 31 (5) de la Loi de 2004
sur l’engagement d’assurer l’avenir de
l’assurance-santé,»;
(b) “or Part III of the latter Act”.
b) «la partie III de cette loi ou».
(3) Clause 22 (4) (a) of the Act is amended by striking out “or Part III of the Commitment to the Future of
Medicare Act, 2004”.
(3) L’alinéa 22 (4) a) de la Loi est modifié par suppression de «ou la partie III de la Loi de 2004 sur
l’engagement d’assurer l’avenir de l’assurance-santé».
23. (1) The following provisions of section 27 of the
Act are amended by striking out “60” and substituting
“90”:
1. Clause (3) (c).
23. (1) Les dispositions suivantes de l’article 27 de
la Loi sont modifiées par remplacement de «60» par
«90» :
1. L’alinéa (3) c).
2. Clause (3) (d), in the portion before subclause
(i).
3. Subsection (4), in the portion before clause (a).
2. L’alinéa (3) d), dans le passage qui précède le
sous-alinéa (i).
3. Le paragraphe (4), dans le passage qui précède
l’alinéa a).
4. Le paragraphe (6).
4. Subsection (6).
(2) Subsection 27 (3) of the Act is amended by striking out “and” at the end of subclause (d) (iii) and by
adding the following clause:
(d.1) despite clauses (c) and (d), may proceed with the
integration at any time if the network notifies the
provider that the network does not intend to give
notice of a proposed decision under subsection (4)
or issue a decision under subsection (6); and
d.1) malgré les alinéas c) et d), peut procéder à
l’intégration en tout temps si le réseau l’avise qu’il
n’a pas l’intention de donner un avis du projet de
décision en vertu du paragraphe (4) ou de prendre
une décision en vertu du paragraphe (6);
following subsections:
des paragraphes suivants :
Exceptions
Exceptions
(3.1) Subsection (3) does not apply to an integration
that requires a decision of the Minister or a director under
the Independent Health Facilities Act or the Long-Term
Care Homes Act, 2007.
(3.1) Le paragraphe (3) ne s’applique pas à une intégration qui est assujettie à une décision du ministre ou
d’un directeur dans le cadre de la Loi sur les établissements de santé autonomes ou de la Loi de 2007 sur les
foyers de soins de longue durée.
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Requirements of notice
Exigences relatives à l’avis
(3.2) A notice under clause (3) (a) must include,
(3.2) L’avis prévu à l’alinéa (3) a) doit comprendre ce
qui suit :
(a) a description of the integration proposed by the
health service provider, including the identity of
the parties involved with the integration;
a) une description de l’intégration proposée par le
fournisseur de services de santé, notamment
l’identité des parties visées par l’intégration;
(b) the health service provider’s analysis of any financial implications, service delivery implications,
health system implication or human resource implications of the proposed integration, where applicable;
b) l’analyse, par le fournisseur de services de santé,
des incidences du projet d’intégration sur, le cas
échéant, les finances, la prestation de services, le
système de santé ou les ressources humaines;
(c) where applicable, a description of any community
engagement processes that the provider used to
consider the proposed integration, and a description
of any issues that were raised in those consultation
processes and the provider’s analysis, if any, of
those issues;
c) une description, le cas échéant, des processus de
participation communautaire auxquels le fournisseur a eu recours pour examiner le projet
d’intégration, ainsi qu’une description des questions soulevées pendant ces processus de consultation et de l’analyse, par le fournisseur, de ces questions, s’il y a lieu;
(d) a description of the proposed timing or staging of
the implementation of the proposed integration;
and
d) une description du délai ou du déroulement proposé en ce qui concerne la mise en oeuvre du projet
d’intégration;
(e) a description of the level of approval received by
the provider within its organization.
e) une description du niveau d’approbation reçu par le
fournisseur au sein de son organisme.
(4) Subsection 27 (4) of the Act is amended by adding the following clause:
(0.a) request more information about the proposed integration from the provider and where such a request
has been made,
0.a) demander au fournisseur d’autres renseignements
sur le projet d’intégration, et si une telle demande a
été faite :
(i) the provider shall provide such information
within 30 days of the request by the network,
and
(i) le fournisseur fournit ces renseignements dans
les 30 jours de la demande du réseau,
(ii) the time limit for the network to take the steps
set out in clauses (a), (b) and (c) shall be extended by an additional 90 days;
(ii) le délai imparti au réseau pour prendre les
mesures énoncées aux alinéas a), b) et c) est
prorogé d’une période additionnelle de 90
jours;
24. Subsection 31 (3) of the Act is amended by striking out “a person who suffers” and substituting “a
person or entity, including a health service provider,
who suffers”.
remplacement de «quiconque subit» par «la personne
ou entité, y compris le fournisseur de services de santé,
qui subit».
25. L’article 33 de la Loi est abrogé.
25. Section 33 of the Act is repealed.
Part:
26. La Loi est modifiée par adjonction de la partie
suivante :
PART V.1
TRANSFER OF COMMUNITY CARE ACCESS
CORPORATIONS TO LOCAL HEALTH
INTEGRATION NETWORKS
PARTIE V.1
TRANSFERT DES SOCIÉTÉS D’ACCÈS AUX SOINS
COMMUNAUTAIRES AUX RÉSEAUX LOCAUX
D’INTÉGRATION DES SERVICES DE SANTÉ
Definition
Définition
34.1 In this Part,
34.1 La définition qui suit s’applique à la présente
partie.
“community care access corporation” means a corporation
continued or incorporated under the Community Care
Access Corporations Act, 2001.
«société d’accès aux soins communautaires» Personne
morale qui est prorogée ou constituée sous le régime de
la Loi de 2001 sur les sociétés d’accès aux soins communautaires.
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Transfer order
Arrêté de transfert ou de mutation
34.2 (1) Despite anything in the Community Care Access Corporations Act, 2001, the Corporations Act or any
other Act, but subject to the processes and requirements
set out in this Part and any regulations made under this
Part, the Minister may make an order,
34.2 (1) Malgré la Loi de 2001 sur les sociétés d’accès
aux soins communautaires, la Loi sur les personnes morales ou toute autre loi, mais sous réserve des méthodes et
exigences énoncées dans la présente partie et des règlements pris en vertu de la présente partie, le ministre peut,
par arrêté :
(a) transferring all of the assets, liabilities, rights and
obligations of a community care access corporation
to the local health integration network that has the
same geographic area as the community care access corporation; and
a) transférer tous les éléments d’actif, éléments de
passif, droits et obligations d’une société d’accès
aux soins communautaires au réseau local
d’intégration des services de santé qui sert la même
zone géographique que la société;
(b) transferring all of the employees of a community
care access corporation to the local health integration network that has the same geographic area as
the community care access corporation.
b) muter tous les employés d’une société d’accès aux
soins communautaires au réseau local d’intégration
des services de santé qui sert la même zone géographique que la société.
Notification requirement
Avis exigé
(2) Before the Minister makes an order under subsection (1), the Minister shall notify the affected community
care access corporation and local health integration network.
(2) Avant de prendre un arrêté en vertu du paragraphe
(1), le ministre doit aviser la société d’accès aux soins
communautaires et le réseau local d’intégration des services de santé visés.
Contents of order
Contenu de l’arrêté
(3) An order made under subsection (1),
(3) L’arrêté pris en vertu du paragraphe (1) :
(a) shall specify a date on which the transfer of assets,
liabilities, rights, obligations or employees, as the
case may be, takes effect; and
a) doit préciser la date à laquelle le transfert des éléments d’actif, éléments de passif, droits et obligations ou la mutation des employés, selon le cas,
prend effet;
(b) may specify that issues arising out of the interpretation of the order be resolved by the method specified in the order.
b) peut préciser que les questions soulevées par
l’interprétation de l’arrêté soient réglées de la façon
que précise celui-ci.
does not apply to an order made under subsection (1).
législation ne s’applique pas à un arrêté pris en vertu du
paragraphe (1).
Notice of order
Avis de l’arrêté
(5) The Minister shall provide each affected community care access corporation and local health integration
network with a copy of the order, and shall make the order available to the public.
(5) Le ministre remet une copie de l’arrêté à chaque
société d’accès aux soins communautaires et à chaque
réseau local d’intégration des services de santé visés et
met l’arrêté à la disposition du public.
Same, duty of corporation
Idem, obligation de la société
(6) Each community care access corporation and local
health integration network that receives a copy of an order
provided under subsection (5) shall,
(6) Chaque société d’accès aux soins communautaires
et chaque réseau local d’intégration des services de santé
qui reçoivent une copie de l’arrêté prévu au paragraphe
(5) :
(a) provide notice of the order and make copies available to affected employees and their bargaining
agents and to other persons or entities whose contracts are affected by the order; and
a) d’une part, avisent de l’arrêté les employés visés et
leurs agents négociateurs ainsi que les autres personnes ou entités dont les contrats sont visés par
l’arrêté et en mettent des copies à leur disposition;
(b) make copies of the order available to the public.
b) d’autre part, mettent des copies de l’arrêté à la disposition du public.
Assumption of rights, obligations, etc.
Prise en charge des droits et des obligations
34.3 (1) If the Minister makes an order under subsection 34.2 (1),
34.3 (1) Si le ministre prend un arrêté en vertu du paragraphe 34.2 (1) :
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(a) the local health integration network affected by the
transfer assumes the operations, activities and affairs of the community care access corporation affected by the transfer, as of the date of the transfer;
and
a) le réseau local d’intégration des services de santé
visé par le transfert prend en charge, à la date du
transfert, les opérations, activités et affaires de la
société d’accès aux soins communautaires visée
par le transfert;
(b) all assets, liabilities, rights and obligations of the
community care access corporation affected by the
transfer, including contractual rights, interests, approvals, registrations and entitlements that exist
immediately before the transfer date continue as
the assets, liabilities, rights and obligations of the
local health integration network affected by the
transfer, and are transferred to the local health integration network affected by the transfer, without
compensation.
b) tous les éléments d’actif, éléments de passif, droits
et obligations de la société d’accès aux soins communautaires visée par le transfert, notamment les
droits contractuels ainsi que les intérêts, approbations et enregistrements qui existent immédiatement avant la date du transfert, continuent d’être
les éléments d’actif, les éléments de passif, les
droits et les obligations du réseau local
d’intégration des services de santé visé par le transfert et lui sont transférés, sans versement
d’indemnité.
Convictions, rulings etc.
Décisions judiciaires ou quasi judiciaires
(2) A conviction against, or ruling, order or judgment
in favour of or against a community care access corporation affected by a transfer may be enforced by or against
the local health integration network affected by the transfer.
(2) Toute décision judiciaire ou quasi judiciaire rendue
en faveur d’une société d’accès aux soins communautaires visée par le transfert ou contre elle peut être exécutée par le réseau local d’intégration des services de santé
visé par le transfert ou à son encontre.
Civil actions, etc.
Actions civiles
(3) The local health integration network affected by a
transfer shall be deemed to be the party plaintiff or the
party defendant, as the case may be, in any civil action
commenced by or against the community care access corporation affected by the transfer before the date of the
transfer.
visé par le transfert est réputé partie demanderesse ou
partie défenderesse, selon le cas, dans toute action civile
intentée avant la date du transfert, soit par la société
d’accès aux soins communautaires visée par le transfert,
soit contre elle.
No change of control
Contrôle intact
(4) A transfer of the assets, liabilities, rights and obligations of the community care access corporation to the
local health integration network shall not constitute a
change of control of the community care access corporation in respect of any asset, liability, right or obligation of
the community care access corporation affected by the
transfer.
(4) Le transfert des éléments d’actif, éléments de passif, droits et obligations de la société d’accès aux soins
communautaires au réseau local d’intégration des services
de santé ne constitue pas un changement de contrôle de la
société relativement aux éléments d’actif, éléments de
passif, droits et obligations de la société visée par le transfert.
No breach, etc.
Non-assimilation à une violation
(5) A transfer is deemed not to,
(5) Un transfert est réputé ne pas :
(a) constitute a breach, termination, repudiation or
frustration of any contract, including a contract of
employment or insurance or a collective agreement;
a) constituer une violation, résiliation, répudiation ou
impossibilité d’exécution d’un contrat, y compris
un contrat de travail ou d’assurance ou une convention collective;
(b) constitute a breach of any Act, regulation or municipal by-law;
b) constituer une violation d’une loi ou d’un règlement, notamment municipal;
(c) constitute an event of default or force majeure;
c) constituer un cas de défaut ou une force majeure;
(d) give rise to a breach, termination, repudiation or
frustration of any licence, permit or other right;
d) donner lieu à une violation, révocation, répudiation
ou impossibilité d’exécution d’un permis, d’une
autorisation ou d’un autre droit;
(e) give rise to any right to terminate or repudiate a
contract, licence, permit or other right; or
e) donner le droit de résilier un contrat ou de révoquer
un droit, notamment un permis ou une autorisation,
ni le droit de les répudier;
(f) give rise to any estoppel.
f) donner lieu à une préclusion.
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No new cause of action
Aucune nouvelle cause d’action
(6) A transfer does not create any new cause of action
in favour of,
(6) Le transfert n’a pas pour effet de créer une nouvelle
cause d’action en faveur :
(a) a holder of a debt instrument that was issued by the
community care access corporation affected by the
transfer before the transfer; or
a) soit du détenteur d’un titre d’emprunt émis par la
société d’accès aux soins communautaires visée
par le transfert avant le transfert;
(b) a party to a contract with the community care access corporation affected by the transfer that was
entered into before the transfer.
b) soit d’une partie à un contrat conclu avec la société
d’accès aux soins communautaires visée par le
transfert avant le transfert.
Transfer binding
Personnes liées par le transfert
(7) Despite any other Act that requires notice or registration of a transfer, a transfer is binding on the local
health integration network affected by the transfer and all
other persons.
(7) Malgré toute autre loi qui exige la remise d’un avis
en cas d’un transfert ou son enregistrement, le transfert lie
le réseau local d’intégration des services de santé visé par
le transfert et les autres personnes.
Non-application of other Acts
Non-application d’autres lois
(8) The Bulk Sales Act, the Land Transfer Tax Act and
the Retail Sales Tax Act do not apply to the transfer.
(8) La Loi sur la vente en bloc, la Loi sur les droits de
cession immobilière et la Loi sur la taxe de vente au détail
ne s’appliquent pas au transfert.
Application of FIPPA
Application de la Loi sur l’accès à l’information et la protection de la
vie privée
(9) The Freedom of Information and Protection of Privacy Act applies to a record that is transferred from a
community care access corporation to a local health integration network, unless the record was in the custody or
control of the community care access corporation before
January 1, 2007.
(9) La Loi sur l’accès à l’information et la protection
de la vie privée s’applique à un dossier qui est transféré
d’une société d’accès aux soins communautaires à un
réseau local d’intégration des services de santé, sauf si la
société avait la garde ou le contrôle du dossier avant le
1er janvier 2007.
Transfer of property held for specified charitable purpose
Transfert de biens détenus à des fins de bienfaisance déterminées
(10) If a Minister’s order transfers to a local health
integration network property that a community care access corporation holds for a specified charitable purpose,
the local health integration network shall use it for the
specified charitable purpose.
(10) Si un arrêté du ministre transfère à un réseau local
d’intégration des services de santé des biens que détient
une société d’accès aux soins communautaires à des fins
de bienfaisance déterminées, le réseau les utilise à ces
fins.
Application
Champ d’application
(11) Subsection (10) applies whether the will, deed or
other document by which the gift, trust, bequest, devise or
grant is made, is executed before or after this section
comes into force.
(11) Le paragraphe (10) s’applique, que le testament,
l’acte ou l’autre document par lequel est fait le don, la
fiducie, le legs ou la cession soit passé avant ou après
l’entrée en vigueur du présent article.
Regulations
Règlements
(12) The Lieutenant Governor in Council may make
regulations,
(12) Le lieutenant-gouverneur en conseil peut, par règlement :
(a) prescribing contracts to which subsections (5) and
(6) do not apply;
a) prescrire des contrats soustraits à l’application des
paragraphes (5) et (6);
(b) prescribing Acts, in addition to those listed in subsection (8), that do not apply to the transfer.
b) prescrire des lois, outre celles énumérées au paragraphe (8), qui ne s’appliquent pas au transfert.
Non-application of s. 38
Non-application de l’art. 38
(13) Section 38 does not apply to the making of regulations under subsection (12).
(13) L’article 38 ne s’applique pas à la prise de règlements en vertu du paragraphe (12).
No expropriation
Aucune expropriation
(14) Nothing in this Part and nothing done or not done
in accordance with this Part constitutes an expropriation
or injurious affection for the purposes of the Expropriations Act or otherwise at law.
(14) Ni la présente partie ni une mesure prise ou non
prise conformément à celle-ci ne constitue une expropriation ou un effet préjudiciable pour l’application de la Loi
sur l’expropriation ou par ailleurs en droit.
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Immunity re transfer
Immunité en ce qui concerne le transfert
(15) No proceeding for damages or otherwise shall be
commenced against a local health integration network, a
director or officer of the network or any person employed
by the network in respect of a claim,
(15) Sont irrecevables les instances en dommagesintérêts ou autres qui sont introduites contre un réseau
local d’intégration des services de santé, un administrateur ou un dirigeant du réseau, ou quiconque est employé
par un réseau, à l’égard d’une réclamation fondée :
(a) that arises in connection with a transfer; or
a) soit sur ce qui est visé par un transfert;
(b) that arises solely in connection with events that
occurred prior to the effective date of the transfer.
b) soit uniquement sur des événements survenus avant
la date d’effet du transfert .
Definition
Définition
(16) In this section and in section 34.4,
(16) La définition qui suit s’applique au présent article
et à l’article 34.4.
“transfer” means a transfer made pursuant to an order
under subsection 34.2 (1).
«transfert» Transfert et mutation effectués conformément
à un arrêté pris en vertu du paragraphe 34.2 (1).
Employees continued
Maintien des employés
34.4 (1) Persons who are employees of a community
care access corporation affected by an order under subsection 34.2 (1) immediately before its dissolution become
employees of the local health integration network affected
by the order as of the date of the transfer.
34.4 (1) Les personnes qui sont des employés d’une
société d’accès aux soins communautaires visée par un
arrêté pris en vertu du paragraphe 34.2 (1), immédiatement avant sa dissolution, deviennent des employés du
réseau local d’intégration des services de santé visé par
l’arrêté à la date du transfert.
Same
Idem
(2) For all purposes, the employment of the employees
described in subsection (1) immediately before and after
the dissolution of the community care access corporation
affected by the transfer is continuous.
(2) À toutes fins, l’emploi des employés visés au paragraphe (1) immédiatement avant et après la dissolution de
la société d’accès aux soins communautaires visée par le
transfert est continu.
Same
Idem
(3) For all purposes, including the purposes of an employment contract, a collective agreement and the Employment Standards Act, 2000, the employment of the
employees described in subsection (1) is not terminated or
severed and those employees are not constructively dismissed because of the transfer.
(3) À toutes fins, notamment aux fins d’un contrat de
travail ou d’une convention collective et pour
l’application de la Loi de 2000 sur les normes d’emploi,
l’emploi des employés visés au paragraphe (1) ne prend
pas fin et ces employés ne sont pas licenciés et ne font pas
l’objet d’un congédiement implicite en raison du transfert.
Terms of employment
Conditions d’emploi
(4) All rights, duties and liabilities relating to all employees and former employees of the community care
access corporation affected by the transfer that are vested
in or bind the community care access corporation affected
by the transfer immediately before the effective date of
the transfer are vested in or bind the local health integration network affected by the transfer instead of the community care access corporation affected by the transfer
immediately after the transfer.
(4) Les droits et obligations rattachés à tous les employés, actuels et anciens, de la société d’accès aux soins
communautaires visée par le transfert qui sont dévolus à
la société, ou qui la lient, immédiatement avant la date
d’effet du transfert, sont dévolus au réseau local
d’intégration des services de santé visé par le transfert, ou
le lient, immédiatement après le transfert.
Application of s. 69 of Labour Relations Act, 1995
Application de l’art. 69 de la Loi de 1995 sur les relations de travail
(5) A transfer is deemed to be a sale of a business under section 69 of the Labour Relations Act, 1995 and that
section applies to the transfer.
(5) Un transfert est réputé une vente d’une entreprise
en application de l’article 69 de la Loi de 1995 sur les
relations de travail et cet article s’applique au transfert.
Non-application of s. 9, Public Sector Labour Relations Transition
Act, 1997
Non-application de l’art. 9 de la Loi de 1997 sur les relations de
travail liées à la transition dans le secteur public
(6) A transfer is not a health services integration for
the purposes of section 9 of the Public Sector Labour
Relations Transition Act, 1997.
(6) Un transfert n’est pas une intégration des services
de santé pour l’application de l’article 9 de la Loi de 1997
sur les relations de travail liées à la transition dans le
secteur public.
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Application of ss. 36 (2) to (7), Public Sector Labour Relations
Transition Act, 1997
Application des par. 36 (2) à (7) de la Loi de 1997 sur les relations de
travail liées à la transition dans le secteur public
(7) Subsections 36 (2) to (7) of the Public Sector Labour Relations Transition Act, 1997 apply to a collective
agreement binding on a local health integration network
and a bargaining agent that represented employees subject
to a transfer.
(7) Les paragraphes 36 (2) à (7) de la Loi de 1997 sur
les relations de travail liées à la transition dans le secteur
public s’appliquent à une convention collective qui lie un
réseau local d’intégration des services de santé et un agent
négociateur qui représentait des employés faisant l’objet
d’un transfert.
Same
Idem
(8) For the purposes of subsections 36 (2) to (7) of the
Public Sector Labour Relations Transition Act, 1997, the
community care access corporation and the local health
integration network subject to a transfer are predecessor
employers and the local health integration network is the
successor employer.
(8) Pour l’application des paragraphes 36 (2) à (7) de
la Loi de 1997 sur les relations de travail liées à la transition dans le secteur public, la société d’accès aux soins
communautaires et le réseau local d’intégration des services de santé qui font l’objet d’un transfert sont les employeurs précédents et le réseau local d’intégration des
services de santé est l’employeur qui succède.
Dissolution order
Arrêté de dissolution
34.5 (1) The Minister may make an order to dissolve a
community care access corporation that is affected by an
order made under subsection 34.2 (1).
34.5 (1) Le ministre peut, par arrêté, dissoudre une
société d’accès aux soins communautaires visée par un
arrêté pris en vertu du paragraphe 34.2 (1).
Dissolution of community care access corporation
Dissolution d’une société d’accès aux soins communautaires
(2) If the Minister makes an order under subsection
(1), the community care access corporation affected by
the order is dissolved as of the date specified in the order,
despite any requirement that would otherwise apply under
the Community Care Access Corporations Act, 2001.
(2) Si le ministre prend un arrêté en vertu du paragraphe (1), la société d’accès aux soins communautaires
visée par l’arrêté est dissoute à la date précisée dans
l’arrêté malgré toute exigence qui s’appliquerait par ailleurs en application de la Loi de 2001 sur les sociétés
d’accès aux soins communautaires.
Members terminated
Perte de la qualité de membre
(3) The persons who are the members of the community care access corporation affected by the order immediately before the dissolution cease to be members on the
day of the dissolution.
(3) Les personnes qui sont membres de la société
d’accès aux soins communautaires visée par l’arrêté immédiatement avant la dissolution de celle-ci cessent d’en
être membres le jour de la dissolution.
Directors terminated
Expiration du mandat des administrateurs
(4) The terms of office of the directors and officers of
the community care access corporation affected by the
order who are in office immediately before its dissolution
are terminated on the day of the dissolution.
(4) Le mandat des administrateurs et des dirigeants de
la société d’accès aux soins communautaires visée par
l’arrêté qui sont en fonction immédiatement avant la dissolution de celle-ci expire le jour de la dissolution.
Final annual report
Rapport annuel final
(5) Despite the dissolution of a community care access
corporation affected by an order, the chair and chief executive officer of the local health integration network affected by the order shall prepare and deliver the annual
report for every fiscal year of the community care access
corporation affected by the order before its dissolution for
which the annual report has not already been delivered by
the community care access corporation.
(5) Malgré la dissolution d’une société d’accès aux
soins communautaires visée par un arrêté, le président et
chef de la direction du réseau local d’intégration des services de santé visé par l’arrêté prépare et remet le rapport
annuel pour chaque exercice de la société visée par
l’arrêté pour lequel celle-ci n’a pas remis de rapport annuel avant sa dissolution.
Same
Idem
(6) For the purposes of subsection (5), if the community care access corporation affected by the order is dissolved in any year on a date other than March 31, its last
fiscal year is deemed to be from the preceding April 1 to
the date of its dissolution.
(6) Pour l’application du paragraphe (5), si la société
d’accès aux soins communautaires visée par l’arrêté est
dissoute à une date autre que le 31 mars d’une année
quelconque, son dernier exercice est réputé courir du
1er avril précédent jusqu’à la date de sa dissolution.
Other filings
Autres dépôts
(7) The chair and chief executive officer of the local
health integration network affected by the order shall
(7) Le président et le chef de la direction du réseau
local d’intégration des services de santé visé par l’arrêté
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make any other filings or reports that a community care
access corporation may make or that would have been
required of the community care access corporation immediately before its dissolution, and the chair and chief executive officer are deemed to have all the rights of a
member, director or officer of the community care access
corporation to make the filings or reports.
déposent les autres documents et remettent les autres rapports que la société d’accès aux soins communautaires
peut préparer ou qui auraient été exigés d’elle immédiatement avant sa dissolution. Le président et le chef de la
direction sont réputés avoir les droits d’un membre, d’un
administrateur ou d’un dirigeant de la société pour le dépôt de documents ou la remise de rapports.
No change of control
Contrôle intact
(8) The dissolution of the community care access corporation affected by the order shall not constitute a
change of control of the community care access corporation in respect of any asset, liability, right or obligation of
the community care access corporation referred to in subsection (1).
(8) La dissolution de la société d’accès aux soins
communautaires visée par l’arrêté ne constitue pas un
changement de contrôle de la société relativement à ses
éléments d’actif, éléments de passif, droits et obligations
visés au paragraphe (1).
27. (1) Section 35 of the Act is repealed and the
27. (1) L’article 35 de la Loi est abrogé et remplacé
par ce qui suit :
Public interest
Intérêt public
35. In making a decision in the public interest under
this Act, the Lieutenant Governor in Council, the Minister
or a local health integration network, as the case may be,
may consider any matter they regard as relevant including, without limiting the generality of the foregoing,
35. Lorsqu’il prend une décision dans l’intérêt public
en vertu de la présente loi, le lieutenant-gouverneur en
conseil, le ministre ou le réseau local d’intégration des
services de santé, selon le cas, peut prendre en considération toute question qu’il estime pertinente, et notamment
les questions qui se rapportent à ce qui suit :
a) la qualité de la gestion et de l’administration du
réseau local d’intégration des services de santé ou
du fournisseur de services de santé, selon le cas;
b) la saine gestion du système de soins de santé en
général;
c) la disponibilité de ressources financières aux fins
de la gestion du système de soins de santé et de la
prestation des services de santé;
d) l’accessibilité aux services de santé dans la zone ou
la sous-zone géographique où se trouve le réseau
local d’intégration des services de santé ou le fournisseur de services de santé, selon le cas;
e) la qualité des soins et des traitements fournis aux
malades.
(a) the quality of the management and administration
of the local health integration network or the health
service provider, as the case may be;
(b) the proper management of the health care system in
general;
(c) the availability of financial resources for the management of the health care system and for the delivery of health care services;
(d) the accessibility to health services in the geographic area or sub-region where the local health integration network or the health service provider, as the
case may be, is located; and
(e) the quality of the care and treatment of patients.
No liability
Immunité
35.1 (1) No proceeding for damages or otherwise,
other than an application for judicial review under the
Judicial Review Procedure Act or a claim for compensation that is permitted under subsection 31 (3), shall be
commenced against any of the following with respect to
any act done or omitted to be done or any decision, directive, standard or order made or issued under this Act
that is done in good faith in the execution or intended
execution of a power or duty under this Act:
35.1 (1) Sont irrecevables les instances en dommagesintérêts ou autres, à l’exception des requêtes en révision
judiciaire présentées en vertu de la Loi sur la procédure
de révision judiciaire ou des demandes d’indemnisation
autorisées par le paragraphe 31 (3), qui sont introduites
contre les personnes ou entités suivantes pour un acte
qu’elles ont accompli ou omis d’accomplir ou pour une
décision ou un arrêté qu’elles ont pris, un ordre ou une
directive qu’elles ont donné, ou une norme qu’elles ont
établie de bonne foi en vertu de la présente loi dans
l’exercice effectif ou censé tel des pouvoirs ou des fonctions que celle-ci leur attribue :
1. La Couronne.
1. The Crown.
2. The Minister.
2. Le ministre.
3. A local health integration network.
3. Un réseau local d’intégration des services de santé.
4. Any member, director or officer of a local health
integration network or an agent or a volunteer of a
local health integration network.
4. Un membre, un administrateur ou un dirigeant d’un
réseau local d’intégration des services de santé, ou
un mandataire ou un bénévole d’un réseau.
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5. Any person employed by the Crown, the Minister
or a local health integration network.
5. Toute personne employée par la Couronne, le ministre ou un réseau local d’intégration des services
de santé.
6. An investigator or a supervisor appointed under
section 12.1 or 12.2, or their staffs.
6. Un enquêteur ou un superviseur nommé en application de l’article 12.1 ou 12.2, ou son personnel.
No protection re negligent health service delivery
Aucune protection : négligence dans la prestation de services de
santé
(2) Nothing in subsection (1) prevents a claim for
compensation with respect to the delivery of services by a
local health integration network or the delivery of services
arranged by a local health integration network, and, for
greater certainty, a local health integration network does
not deliver services, and services are not arranged by a
local health integration network, when the network funds
services under subsection 19 (1) to be delivered by a
health service provider.
(2) Le paragraphe (1) n’a pas pour effet d’empêcher la
présentation d’une demande d’indemnisation à l’égard de
la prestation des services fournis ou organisés par un réseau local d’intégration des services de santé. Il est entendu qu’un réseau local d’intégration des services de santé
ne fournit pas ni n’organise de services quand il finance la
prestation de services par un fournisseur de services de
santé en vertu du paragraphe 19 (1).
(2) Paragraph 6 of subsection 35.1 (1) of the Act, as
enacted by subsection (1), is amended by striking out
“under section 12.1 or 12.2” and substituting “under
section 12.1, 12.2, 21.1 or 21.2”.
(2) La disposition 6 du paragraphe 35.1 (1) de la
Loi, telle qu’elle est édictée par le paragraphe (1), est
modifiée par remplacement de «en application de
l’article 12.1 ou 12.2» par «en application de l’article
12.1, 12.2, 21.1 ou 21.2».
28. Subsection 37 (1) of the Act is amended by adding the following clause:
(i.1) respecting the content or terms and conditions of a
service accountability agreement under section 20;
i.1) traiter du contenu ou des conditions d’une entente
de responsabilisation en matière de services visée à
l’article 20;
section:
suivant :
Information and reports
Renseignements et rapports
37.1 The Lieutenant Governor in Council may make
regulations requiring prescribed persons and entities to
provide information and reports to a local health integration network about the following for planning, performance management and any other duties of a network:
37.1 Le lieutenant-gouverneur en conseil peut, par
règlement, exiger que les personnes et entités prescrites
fournissent des renseignements et des rapports à un réseau
local d’intégration des services de santé au sujet des éléments suivants aux fins, d’une part, de la planification des
activités du réseau et, d’autre part, de la gestion du rendement de son personnel et de toute autre fonction d’un
réseau :
1. Physician resource issues such as opening and closing of practices, transitions and changes to practices, retirements from practices and change of location of practices.
1. Les questions liées aux effectifs médicaux, comme
l’ouverture et la fermeture de cabinets de médecins, les transitions et les changements au sein des
cabinets, les départs à la retraite et les changements
d’emplacement des cabinets.
2. Physician practices in the local health system such
as policies for accepting and discharging patients,
practice profiles, practice wait-times, and practice
coverage for after-hours services, vacations, leaves
and other absences.
2. Les pratiques médicales dans le système de santé
local, comme les politiques d’acceptation et de
mise en congé des patients, le profil des cabinets,
les délais d’attente et la permanence après les
heures normales de travail, pendant les vacances,
les congés et d’autres absences.
30. Sections 39 and 40 of the Act are repealed and
the following substituted:
30. Les articles 39 et 40 de la Loi sont abrogés et
remplacés par ce qui suit :
Corporation
Personne morale
39. (1) The Lieutenant Governor in Council may by
regulation incorporate a corporation without share capital
to provide shared services to local health integration networks and others.
39. (1) Le lieutenant-gouverneur en conseil peut, par
règlement, constituer une personne morale sans capitalactions pour fournir des services partagés aux réseaux
locaux d’intégration des services de santé et à d’autres
entités.
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Matters in regulations
Questions traitées par règlement
(2) The Lieutenant Governor in Council may, in the
regulations incorporating the corporation without share
capital, or in other regulations, make regulations with
respect to the following:
(2) Dans les règlements qui constituent la personne
morale sans capital-actions, ou dans d’autres règlements,
le lieutenant-gouverneur en conseil peut, par règlement,
traiter de ce qui suit :
1. The name of the corporation.
1. La dénomination sociale de la personne morale.
2. The conditions and restrictions that apply with respect to the corporation.
2. Les conditions et restrictions qui s’appliquent à
l’égard de la personne morale.
3. The composition of the corporation.
3. La composition de la personne morale.
4. The composition of the board of directors and the
appointment and remuneration of directors. As an
option, the regulation may authorize the Lieutenant
Governor in Council to make the appointment and
determine the remuneration.
5. The objects of the corporation, which may include
the provision of shared services to local health integration networks, health service providers or other entities whose primary function is to deliver
health services.
4. La composition du conseil d’administration ainsi
que la nomination et la rémunération des administrateurs. Le règlement peut, à la place, autoriser le
lieutenant-gouverneur en conseil à nommer les
administrateurs et à fixer leur rémunération.
5. Les objets de la personne morale, lesquels peuvent
comprendre la prestation de services partagés aux
réseaux locaux d’intégration des services de santé,
aux fournisseurs de services de santé ou à d’autres
entités dont la fonction principale consiste à fournir
des services de santé.
6. La capacité ainsi que les droits, les pouvoirs et les
privilèges de la personne morale et les restrictions
auxquelles ils sont assujettis.
7. Le mandat d’un président et d’un ou de plusieurs
vice-présidents, et leurs fonctions.
8. La nomination et la rémunération du chef de la
direction. Le règlement peut, à la place, autoriser le
lieutenant-gouverneur en conseil à nommer le chef
de la direction et à fixer sa rémunération.
6. The capacity, rights, powers and privileges of the
corporation and any restrictions on them.
7. The office of a chair and one or more vice-chairs,
and their functions.
8. The appointment and remuneration of the chief
executive officer. As an option, the regulation may
authorize the Lieutenant Governor in Council to
make the appointment and determine the remuneration.
9. The appointment of auditors.
9. La nomination des vérificateurs.
10. The frequency, nature and scope of reporting from
the corporation and to whom the reports will be
given.
11. The corporation’s authority to employ or otherwise
engage persons for the proper conduct of its activities.
12. Requirements for the investigation, review and
audits of the corporation by the Minister or his or
her delegate.
10. La fréquence, la nature et la portée des rapports de
la personne morale ainsi que les destinataires des
rapports.
11. Le pouvoir de la personne morale d’employer ou
d’engager autrement des personnes pour la bonne
conduite de ses activités.
12. Les exigences applicables aux enquêtes, examens
et vérifications de la personne morale par le ministre ou son délégué.
13. The application or non-application to the corporation of the Business Corporations Act, the Corporations Information Act or the Corporations Act or
any provisions of those Acts or any successor of
those Acts or any regulations under any of those
Acts.
13. L’application ou la non-application à la personne
morale de la Loi sur les sociétés par actions, de la
Loi sur les renseignements exigés des personnes
morales ou de la Loi sur les personnes morales ou
de toute loi qui les remplace ou de tout règlement
pris en vertu de ces lois.
14. The procedures and administration of the corporation.
14. Le mode de fonctionnement et l’administration de
la personne morale.
15. Directives and policies that the Minister may issue
to the corporation relating to the exercise of its
powers or the performance of its duties and the duty of the board of directors to ensure that the directives and policies are implemented promptly and
efficiently.
15. Les directives données et les politiques communiquées par le ministre à la personne morale relativement à l’exercice de ses pouvoirs ou de ses fonctions et à l’obligation du conseil d’administration
de veiller à ce que ces directives et politiques
soient mises en oeuvre promptement et efficacement.
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16. Any other matters the Lieutenant Governor in
Council considers necessary or desirable.
25
16. Toute autre question que le lieutenant-gouverneur
en conseil estime nécessaire ou souhaitable.
Crown agency or not
Organisme de la Couronne
(3) The corporation is not a Crown agent for any purpose unless a regulation specifies otherwise.
(3) Sauf disposition contraire d’un règlement, la personne morale n’est à aucune fin un mandataire de la Couronne.
(4) Section 38 does not apply to the making of a regulation under this section.
(4) L’article 38 ne s’applique pas à la prise de règlements en vertu du présent article.
No personal liability
Immunité
(5) No action or other proceeding for damages may be
instituted against any member, director, officer, employee
or agent of the corporation for any act done in the execution or intended execution of the person’s duty or for any
alleged neglect or default in the execution in good faith of
the person’s duty.
(5) Sont irrecevables les actions ou autres instances en
dommages-intérêts introduites contre un membre, un administrateur, un dirigeant, un employé ou un mandataire
de la personne morale pour un acte accompli dans
l’exercice effectif ou censé tel des fonctions de la personne ou pour une négligence ou un manquement qu’elle
aurait commis dans l’exercice de bonne foi de ses fonctions.
Non-application of single employer rule
Non-application de la règle d’un seul employeur
(6) Subsection 1 (4) of the Labour Relations Act, 1995
does not apply to the corporation.
(6) Le paragraphe 1 (4) de la Loi de 1995 sur les relations de travail ne s’applique pas à la personne morale.
Restrictions on borrowing, etc.
Restrictions : emprunts
(7) If the corporation is a Crown agent for any purpose,
it shall not, as a Crown agent, borrow, invest funds or
manage financial risks, unless it is permitted to do so by
regulation and unless the activity is authorized by a bylaw that has been approved in writing by the Minister of
Health and Long-Term Care and by the Minister of Finance.
(7) La personne morale qui est un mandataire de la
Couronne à quelque fin que ce soit ne peut, à ce titre, contracter des emprunts, effectuer des placements ou gérer
des risques financiers, à moins que, d’une part, il lui soit
permis par règlement de le faire et, d’autre part, l’activité
soit autorisée par un règlement administratif que le ministre de la Santé et des Soins de longue durée et le ministre des Finances ont approuvé par écrit.
Same
Idem
(8) Subject to subsection (9), the Ontario Financing
Authority shall co-ordinate and arrange all borrowing,
investing of funds and managing of financial risks for the
corporation.
(8) Sous réserve du paragraphe (9), l’Office ontarien
de financement coordonne et organise les activités
d’emprunt, de placement et de gestion des risques financiers pour la personne morale.
Direction re borrowing, etc.
Directives : activités d’emprunt et autres opérations
(9) The Minister of Finance may, in writing, direct a
person other than the Ontario Financing Authority to coordinate and arrange the borrowing, investing of funds
and managing of financial risks for the corporation.
(9) Le ministre des Finances peut, par écrit, ordonner à
une personne autre que l’Office ontarien de financement
de coordonner et d’organiser les activités d’emprunt, de
placement et de gestion des risques financiers pour la personne morale.
Same
Idem
(10) The direction under subsection (9) may be general
or specific and may include terms and conditions that the
Minister of Finance considers advisable.
(10) L’ordre visé au paragraphe (9) peut avoir une portée générale ou particulière et peut être assorti des conditions que le ministre des Finances estime souhaitables.
Use of certain revenues
Utilisation de certaines recettes
(11) If the corporation is a Crown agent for any purpose, the revenues that it receives as a Crown agent shall
be used for the purposes specified by regulation, and for
no other purpose.
(11) La personne morale qui est un mandataire de la
Couronne à quelque fin que ce soit ne peut affecter les
recettes qu’elle touche à ce titre qu’aux fins précisées par
règlement et à nulle autre fin.
Definition
Définition
(12) In this section and in section 40,
(12) La définition qui suit s’applique au présent article
et à l’article 40.
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“corporation” means the corporation without share capital
incorporated by regulation under subsection (1).
«personne morale» Personne morale sans capital-actions
constituée par règlement en vertu du paragraphe (1).
Transfer order
Arrêté de transfert ou de mutation
40. (1) Despite anything in the Corporations Act or
any other Act, but subject to the processes and requirements set out in this section and any regulations made
under this section, the Minister may make an order,
40. (1) Malgré la Loi sur les personnes morales ou
toute autre loi, mais sous réserve des méthodes et exigences énoncées au présent article et des règlements pris
en vertu du présent article, le ministre peut, par arrêté :
(a) transferring the assets, liabilities, rights and obligations from the Ontario Association of Community
Care Access Centres or its successor corporation to
a corporation without share capital incorporated
under subsection 39 (1); and
a) transférer les éléments d’actif, éléments de passif,
droits et obligations de l’Ontario Association of
Community Care Access Centres ou de la personne
morale remplaçante à une personne morale sans
capital-actions constituée en vertu du paragraphe
39 (1);
(b) transferring employees from the Ontario Association of Community Care Access Centres or its successor corporation to a corporation without share
capital incorporated under subsection 39 (1), and
transferring the rights, duties and obligations of the
Ontario Association of Community Care Access
Centres or its successor corporation to its employees and former employees.
b) muter les employés de l’Ontario Association of
Community Care Access Centres ou de la personne
morale remplaçante à une personne morale sans
capital-actions constituée en vertu du paragraphe
39 (1), et transférer les droits, fonctions et obligations de l’Ontario Association of Community Care
Access Centres ou de la personne morale remplaçante à ses employés, actuels et anciens.
Notification requirement
Avis exigé
(2) Before the Minister makes an order under subsection (1), the Minister shall notify the affected corporations.
(2) Avant de prendre un arrêté en vertu du paragraphe
(1), le ministre doit aviser les personnes morales visées.
Contents of order
Contenu de l’arrêté
(3) An order made under subsection (1),
(3) L’arrêté pris en vertu du paragraphe (1) :
(a) shall specify a date on which the transfer of assets,
liabilities, rights, obligations or employees, as the
case may be, takes effect; and
a) doit préciser la date à laquelle le transfert des éléments d’actif, éléments de passif, droits et obligations ou la mutation des employés, selon le cas,
prend effet;
(b) may specify that issues arising out of the interpretation of the order be resolved by the method specified in the order.
b) peut préciser que les questions soulevées par
l’interprétation de l’arrêté sont réglées de la façon
que précise celui-ci.
does not apply to an order made under subsection (1).
législation ne s’applique pas à un arrêté pris en vertu du
paragraphe (1).
Notice of order
Avis de l’arrêté
(5) The Minister shall provide each affected corporation with a copy of the order, and shall make the order
available to the public.
(5) Le ministre remet une copie de l’arrêté à chaque
personne morale visée et met l’arrêté à la disposition du
public.
Same, duty of corporation
Idem, obligation de la personne morale
(6) Each corporation that receives a copy of an order
provided under subsection (5) shall,
(6) Chaque personne morale qui reçoit une copie de
l’arrêté conformément au paragraphe (5) :
(a) provide notice of the order and make copies available to affected employees and their bargaining
agents and to other persons or entities whose contracts are affected by the order; and
a) d’une part, avise de l’arrêté les employés visés et
leurs agents négociateurs ainsi que les autres personnes ou entités dont les contrats sont visés par
l’arrêté et en met des copies à leur disposition;
(b) make copies of the order available to the public.
b) d’autre part, met des copies de l’arrêté à la disposition du public.
Rules regarding a transfer of assets by order
Règles : transfert d’éléments d’actif par arrêté
(7) The following provisions apply to the transfer of
(7) Sauf disposition contraire des règlements, les dis-
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assets, liabilities, rights and obligations to a corporation
without share capital incorporated under subsection 39 (1)
in accordance with an order made under subsection (1),
unless the regulations provide otherwise:
positions suivantes s’appliquent au transfert des éléments
d’actif, éléments de passif, droits et obligations à une personne morale sans capital-actions constituée en vertu du
paragraphe 39 (1) conformément à un arrêté pris en vertu
du paragraphe (1) :
1. A conviction against, or ruling, order or judgment
in favour of or against a person from whom any assets, liabilities, rights or obligations are transferred
to the corporation may be enforced by or against
the corporation.
1. Toute décision judiciaire ou quasi judiciaire rendue
en faveur d’une personne dont des éléments d’actif,
éléments de passif, droits et obligations sont transférés à la personne morale, ou contre elle, peut être
exécutée par la personne morale ou à son encontre.
2. The corporation shall be deemed to be the party
plaintiff or the party defendant, as the case may be,
in any civil action commenced by or against a person from whom any assets, liabilities, rights or obligations are transferred to the corporation before
the date of the transfer.
2. La personne morale est réputée partie demanderesse ou partie défenderesse, selon le cas, dans
toute action civile intentée avant la date du transfert, soit par une personne dont des éléments
d’actif, éléments de passif, droits et obligations
sont transférés à la personne morale, soit contre
elle.
3. A transfer of the assets, liabilities, rights and obligations from a person to the corporation shall not
constitute a change of control in respect of any asset, liability, right or obligation of the person.
3. Le transfert des éléments d’actif, éléments de passif, droits et obligations d’une personne à une personne morale ne constitue pas un changement de
contrôle relativement aux éléments d’actif, éléments de passif, droits et obligations de la personne.
4. Le transfert des éléments d’actif, éléments de passif, droits et obligations d’une personne à une personne morale est réputé ne pas :
i. constituer une violation, résiliation, répudiation ou impossibilité d’exécution d’un contrat,
y compris un contrat de travail ou
d’assurance,
ii. constituer une violation d’une loi ou d’un
règlement, notamment municipal,
iii. constituer un cas de défaut ou une force majeure,
iv. donner lieu à une violation, révocation, répudiation ou impossibilité d’exécution d’un
permis, d’une autorisation ou d’un autre droit,
v. donner le droit de résilier un contrat ou de
révoquer un droit, notamment un permis ou
une autorisation, ni le droit de les répudier,
vi. donner lieu à une préclusion.
4. A transfer of the assets, liabilities, rights and obligations from a person to the corporation is deemed
not to,
i. constitute a breach, termination, repudiation
or frustration of any contract, including a contract of employment or insurance,
ii. constitute a breach of any Act, regulation or
municipal by-law,
iii. constitute an event of default or force
majeure,
iv. give rise to a breach, termination, repudiation
or frustration of any licence, permit or other
right,
v. give rise to any right to terminate or repudiate
a contract, licence, permit or other right, or
vi. give rise to any estoppel.
5. A transfer of the assets, liabilities, rights and obligations from a person to the corporation does not
create any new cause of action in favour of,
5. Le transfert des éléments d’actif, éléments de passif, droits et obligations d’une personne à une personne morale n’a pas pour effet de créer une nouvelle cause d’action en faveur :
i. soit du détenteur d’un titre d’emprunt émis
par la personne avant le transfert,
ii. soit d’une partie à un contrat conclu avec la
personne avant le transfert.
6. Malgré toute autre loi qui exige la remise d’un avis
en cas d’un transfert ou son enregistrement, le
transfert lie la personne morale et les autres personnes.
i. a holder of a debt instrument that was issued
by the person before the transfer, or
ii. a party to a contract with the person that was
entered into before the transfer.
6. Despite any other Act that requires notice or registration of a transfer, a transfer is binding on the
corporation and all other persons.
7. The Bulk Sales Act, the Land Transfer Tax Act and
the Retail Sales Tax Act do not apply to the transfer.
7. La Loi sur la vente en bloc, la Loi sur les droits de
cession immobilière et la Loi sur la taxe de vente
au détail ne s’appliquent pas au transfert.
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8. Nothing in this section and nothing done or not
done in accordance with this section constitutes an
expropriation or injurious affection for the purposes of the Expropriations Act or otherwise at law.
8. Ni le présent article ni une mesure prise ou non
prise conformément à celui-ci ne constitue une expropriation ou un effet préjudiciable pour
l’application de la Loi sur l’expropriation ou par
ailleurs en droit.
9. Sont irrecevables les instances en dommagesintérêts ou autres qui sont introduites contre la personne morale, un administrateur ou un dirigeant de
la personne morale, ou quiconque est employé par
la personne morale à l’égard d’une réclamation
fondée :
i. d’une part, sur ce qui est visé par un transfert
conformément à un règlement pris en vertu du
présent article,
ii. d’autre part, uniquement sur des événements
survenus avant la date d’effet du transfert.
9. No proceeding for damages or otherwise shall be
commenced against the corporation, a director or
officer of the corporation or any person employed
by the corporation in respect of a claim,
i. that arises in connection with a transfer in
accordance with a regulation made under this
section, and
ii. that arises solely in connection with events
that occurred prior to the effective date of the
transfer.
Rules regarding a transfer of employees by order
Règles : mutation d’employés par arrêté
(8) The following provisions apply to an order to transfer employees from the Ontario Association of Community Care Access Centres or its successors to a corporation
without share capital incorporated under subsection 39 (1)
in accordance with an order made under subsection (1),
unless the regulations provide otherwise:
(8) Sauf disposition contraire des règlements, les dispositions suivantes s’appliquent à l’arrêté de mutation
d’employés de l’Ontario Association of Community Care
Access Centres ou de ses successeurs à une personne morale sans capital-actions constituée en vertu du paragraphe
39 (1) conformément à un arrêté pris en vertu du paragraphe (1) :
1. Les personnes qui sont des employés de l’Ontario
Association of Community Care Access Centres
deviennent des employés de la personne morale à
la date du transfert.
2. À toutes fins, l’emploi des employés visés à la disposition 1 ne prend pas fin et ces employés ne font
pas l’objet d’un congédiement implicite en raison
du transfert à la personne morale.
3. À toutes fins, l’emploi des employés visés à la disposition 1 immédiatement avant et après le transfert à la personne morale est continu.
4. Les conditions d’emploi de chacun des employés
visés à la disposition 1 immédiatement avant le
transfert à la personne morale demeurent leurs
conditions d’emploi immédiatement après le transfert.
1. Persons who are employees of the Ontario Association of Community Care Access Centres become
employees of the corporation with effect from the
date of the transfer.
2. For all purposes, the employment of the employees
described in paragraph 1 is not terminated and
those employees are not constructively dismissed
because of a transfer to the corporation.
3. For all purposes, the employment of the employees
described in paragraph 1 immediately before and
after the transfer to the corporation is continuous.
4. The terms and conditions of employment for each
of the employees described in paragraph 1 as they
existed immediately before the transfer to the corporation continue to be the terms and conditions of
their employment with the corporation immediately
following the transfer.
Regulations
Règlements
(9) The Lieutenant Governor in Council may make
regulations,
(9) Le lieutenant-gouverneur en conseil peut, par règlement :
(a) governing the transfer of assets, liabilities, rights
and obligations in accordance with an order made
under subsection (1);
a) régir le transfert des éléments d’actif, éléments de
passif, droits et obligations conformément à un arrêté pris en vertu du paragraphe (1);
(b) governing the transfer of employees in accordance
with an order made under subsection (1);
b) régir la mutation d’employés conformément à un
arrêté pris en vertu du paragraphe (1);
(c) prescribing Acts, in addition to those listed in paragraph 7 of subsection (7), that do not apply to a
transfer.
c) prescrire des lois, en plus de celles qui sont énumérées à la disposition 7 du paragraphe (7), qui ne
s’appliquent pas à un transfert.
(10) Section 38 does not apply to the making of a regulation under this section.
(10) L’article 38 ne s’applique pas à la prise de règlements en vertu du présent article.
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OTHER AMENDMENTS, REPEALS, ETC.
29
AUTRES MODIFICATIONS ET ABROGATIONS
Broader Public Sector Accountability Act, 2010
Loi de 2010 sur la responsabilisation du secteur parapublic
31. (1) The definition of “community care access
corporation” in subsection 1 (1) of the Broader Public
Sector Accountability Act, 2010 is repealed.
31. (1) La définition de «société d’accès aux soins
communautaires» au paragraphe 1 (1) de la Loi de
2010 sur la responsabilisation du secteur parapublic est
abrogée.
(2) Clause (e) of the definition of “designated
broader public sector organization” in subsection 1 (1)
of the Act is repealed.
(2) L’alinéa e) de la définition de «organisme désigné du secteur parapublic» au paragraphe 1 (1) de la
Loi est abrogé.
Broader Public Sector Executive Compensation Act, 2014
Loi de 2014 sur la rémunération des cadres du secteur parapublic
32. Paragraph 8 of subsection 3 (1) of the Broader
Public Sector Executive Compensation Act, 2014 is repealed.
32. La disposition 8 du paragraphe 3 (1) de la Loi de
2014 sur la rémunération des cadres du secteur parapublic est abrogée.
Commitment to the Future of Medicare Act, 2004
Loi de 2004 sur l’engagement d’assurer l’avenir de l’assurance-santé
33. Part III of the Commitment to the Future of
Medicare Act, 2004 is repealed.
33. La partie III de la Loi de 2004 sur l’engagement
d’assurer l’avenir de l’assurance-santé est abrogée.
Community Care Access Corporations Act, 2001
Loi de 2001 sur les sociétés d’accès aux soins communautaires
34. The Community Care Access Corporations Act,
2001 is repealed.
34. La Loi de 2001 sur les sociétés d’accès aux soins
communautaires est abrogée.
Electronic Cigarettes Act, 2015
Loi de 2015 sur les cigarettes électroniques
35. (1) Clause (a) of the definition of “home healthcare worker” in subsection 11 (5) of the Electronic
Cigarettes Act, 2015 is repealed.
35. (1) L’alinéa a) de la définition de «travailleur
de la santé à domicile» au paragraphe 11 (5) de la Loi
de 2015 sur les cigarettes électroniques est abrogé.
(2) The definition of “home health-care worker” in
subsection 11 (5) of the Act is amended by adding the
following clause:
(2) La définition de «travailleur de la santé à domicile» au paragraphe 11 (5) de la Loi est modifiée par
(a.1) a local health integration network as defined in
section 2 of the Local Health System Integration
Act, 2006, or
a.1) soit un réseau local d’intégration des services de
santé au sens de l’article 2 de la Loi de 2006 sur
l’intégration du système de santé local;
Employment Standards Act, 2000
Loi de 2000 sur les normes d’emploi
36. (1) Section 74.2 of the Employment Standards
Act, 2000 is amended by striking out “Long-Term Care
Act, 1994” in the portion before clause (a) and substituting “Home Care and Community Services Act,
1994”.
36. (1) L’article 74.2 de la Loi de 2000 sur les
normes d’emploi est modifié par remplacement de «Loi
de 1994 sur les soins de longue durée» par «Loi de 1994
sur les services de soins à domicile et les services communautaires» dans le passage qui précède l’alinéa a).
(2) Section 74.2 of the Act is repealed.
(2) L’article 74.2 de la Loi est abrogé.
(3) The Act is amended by adding the following
section:
(3) La Loi est modifiée par adjonction de l’article
suivant :
Assignment employees
Employés ponctuels
74.2.1 This Part does not apply in relation to an individual who is an assignment employee assigned to provide professional services, personal support services or
homemaking services as defined in the Home Care and
Community Services Act, 1994 if the assignment is made
under a contract between,
74.2.1 La présente partie ne s’applique pas à l’égard
d’un particulier qui est un employé ponctuel affecté à la
fourniture de services professionnels, de services de soutien personnel ou de services d’aides familiales au sens de
la Loi de 1994 sur les services de soins à domicile et les
services communautaires si l’affectation est effectuée aux
termes d’un contrat conclu entre :
(a) the individual and a local health integration network within the meaning of the Local Health System Integration Act, 2006; or
a) soit le particulier et un réseau local d’intégration
des services de santé au sens de la Loi de 2006 sur
(b) an employer of the individual and a local health
integration network within the meaning of the Local Health System Integration Act, 2006.
b) soit un employeur du particulier et un réseau local
d’intégration des services de santé au sens de la Loi
de 2006 sur l’intégration du système de santé local.
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Excellent Care for All Act, 2010
Loi de 2010 sur l’excellence des soins pour tous
37. (1) Clause (b) of the definition of “health sector
organization” in section 1 of the Excellent Care for All
Act, 2010 is repealed.
37. (1) L’alinéa b) de la définition de «organisme
du secteur de la santé» à l’article 1 de la Loi de 2010
sur l’excellence des soins pour tous est abrogé.
(2) The definition of “health sector organization” in
section 1 of the Act is amended by striking out “and”
at the end of clause (c) and by adding the following
clause:
(2) La définition de «organisme du secteur de la
santé» à l’article 1 de la Loi est modifiée par adjonction de l’alinéa suivant :
(c.1) a local health integration network within the meaning of the Local Health System Integration Act,
2006, but only with respect to,
c.1) un réseau local d’intégration des services de santé
au sens de la Loi de 2006 sur l’intégration du système de santé local, mais seulement en ce qui concerne ce qui suit, selon le cas :
(i) professional services, personal support services and homemaking services as defined in
the Home Care and Community Services Act,
1994 provided by or arranged by a local
health integration network under that Act,
(i) les services professionnels, les services de
soutien personnel et les services d’aides familiales au sens de la Loi de 1994 sur les services de soins à domicile et les services communautaires fournis ou organisés par un réseau local d’intégration des services de santé
en application de cette loi,
(ii) the placement of a person into,
(ii) le placement de personnes :
(A) a long-term care home within the meaning of the Long-Term Care Homes Act,
2007,
(A) dans des foyers de soins de longue durée au sens de la Loi de 2007 sur les
foyers de soins de longue durée,
(B) a supportive housing program funded
by the Ministry of Health and LongTerm Care or a local health integration
network under the Home Care and
Community Services Act, 1994,
(B) dans un programme de logements avec
services de soutien financé par le ministère de la Santé et des Soins de longue
durée ou un réseau local d’intégration
des services de santé en application de
la Loi de 1994 sur les services de soins
à domicile et les services communautaires,
(C) a chronic care or rehabilitation bed in a
hospital within the meaning of the Public Hospitals Act, or
(C) dans des lits de malades chroniques ou
des lits de réadaptation d’hôpitaux dans
un hôpital au sens de la Loi sur les hôpitaux publics,
(D) an adult day program that is provided
under the Home Care and Community
Services Act, 1994, or
(D) dans des programmes de jour pour
adultes prévus en application de la Loi
de 1994 sur les services de soins à domicile et les services communautaires,
(iii) any other services that are prescribed, and
(iii) les autres services qui sont prescrits;
(3) Subsection 10 (1) of the Act is amended by adding “as a corporation without share capital” at the
end.
insertion de «à titre de personne morale sans capitalactions» après «prorogé».
sections:
(4) La Loi est modifiée par adjonction des articles
suivants :
Crown agent
Mandataire de la Couronne
10.1 The Council is for all its purposes an agent of the
Crown and its powers may be exercised only as an agent
of the Crown.
10.1 Le Conseil est, à toutes ses fins, un mandataire de
la Couronne et il exerce ses pouvoirs uniquement en cette
qualité.
Powers of Council
Pouvoirs du Conseil
10.2 (1) The Council has the capacity, rights, powers
and privileges of a natural person for carrying out its
functions, except as limited by this Act or the regulations.
10.2 (1) Le Conseil a la capacité ainsi que les droits,
pouvoirs et privilèges d’une personne physique pour
exercer ses fonctions, sous réserve des restrictions
qu’imposent la présente loi ou les règlements.
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Revenues and assets
Recettes et éléments d’actif
(2) Despite Part I of the Financial Administration Act,
the assets and revenues of the Council do not form part of
the Consolidated Revenue Fund.
(2) Malgré la partie I de la Loi sur l’administration
financière, les éléments d’actif et les recettes du Conseil
ne font pas partie du Trésor.
Use of revenues
Utilisation des recettes
(3) The Council shall carry out its operations without
the purpose of gain for its members and all revenues of
the Council, including all money or assets received by the
Council by grant, gift, contribution, profit or otherwise,
shall be used to further its functions.
(3) Le Conseil exerce ses activités sans but lucratif
pour ses membres et les recettes, y compris toutes les
sommes d’argent ou tous les éléments d’actif qu’il reçoit,
notamment sous forme de cession, subvention, don, contribution et profit, servent à l’exercice de ses fonctions.
Lieutenant Governor in Council approval
Approbation du lieutenant-gouverneur en conseil
(4) The Council shall not, without the approval of the
Lieutenant Governor in Council,
(4) Le Conseil ne doit pas faire ce qui suit sans
l’approbation du lieutenant-gouverneur en conseil :
(a) acquire, dispose, lease, mortgage, charge, hypothecate or otherwise transfer or encumber any interest
in real property;
a) transférer ou grever, notamment en acquérant, en
aliénant, en louant à bail ou en nantissant, notamment par hypothèque ou charge, un intérêt sur un
bien immeuble;
(b) pledge, charge or encumber any of its personal
property;
b) mettre en gage ou grever, notamment par charge,
un de ses biens meubles;
(c) create a subsidiary; or
c) créer une filiale;
(d) do anything else that the regulations provide may
not be done without such approval.
d) exercer les autres fonctions qui, selon ce que prévoient les règlements, ne peuvent être exercées
sans une telle approbation.
Investments, etc.
Placements et autres opérations
10.3 (1) The power of the Council to borrow, make
short-term investments of funds, manage risk associated
with financing and investment or incur liabilities in order
to facilitate financing by others may only be exercised
under the authority of a by-law that has been approved in
writing by the Minister and the Minister of Finance.
10.3 (1) Le pouvoir qu’a le Conseil de contracter des
emprunts, de faire des placements de fonds à court terme,
de gérer les risques rattachés au financement et aux placements, ou de contracter des dettes pour faciliter le financement par d’autres ne peut être exercé qu’en vertu
d’un règlement administratif que le ministre et le ministre
des Finances ont approuvé par écrit.
Co-ordination of financing activities
Coordination des activités de financement
(2) All borrowing, financing, short-term investment of
funds and financial risk management activities of the
Council shall be co-ordinated and arranged by the Ontario
Financing Authority, unless the Minister of Finance approves otherwise.
(2) L’Office ontarien de financement coordonne et
organise les activités d’emprunt, de financement, de placement de fonds à court terme et de gestion des risques
financiers du Conseil, sauf approbation contraire du ministre des Finances.
Control
Contrôle
10.4 (1) The affairs of the Council are under the management and control of its board of directors.
10.4 (1) Le conseil d’administration du Conseil assure
la gestion et le contrôle des affaires du Conseil.
By-laws
Règlements administratifs
(2) The Council may, subject to the approval of the
Minister, pass by-laws and resolutions for conducting and
managing its affairs, including,
(2) Le Conseil peut, sous réserve de l’approbation du
ministre, adopter des règlements administratifs et des résolutions pour traiter de la conduite et de la gestion de ses
affaires, notamment :
(a) appointing officers and assigning to them such
powers and duties as the board considers appropriate;
a) nommer des dirigeants et leur attribuer les pouvoirs
et fonctions que le Conseil juge appropriés;
(b) maintaining bank accounts and making other banking arrangements;
b) tenir des comptes en banque et prendre d’autres
dispositions bancaires;
(c) establishing committees, including committees to
develop recommendations about clinical care
standards and performance measures; and
c) créer des comités, notamment pour la formulation
de recommandations sur les normes de soins cliniques et les mesures de rendement;
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(d) anything else provided for in the regulations.
d) exercer les autres fonctions que prévoient les règlements.
Delegation of Council functions
Délégation des fonctions du Conseil
(3) Subject to the approval of the Minister, the Council
may by by-law delegate any of its powers or functions to
a committee that is established under the by-laws of the
Council.
(3) Sous réserve de l’approbation du ministre, le Conseil peut, par règlement administratif, déléguer ses pouvoirs ou fonctions à un comité créé en vertu de ses règlements administratifs.
Conditions, etc. and delegation
Conditions ou restrictions : délégation
(4) A delegation under subsection (3) is subject to any
conditions or restrictions set out in the by-law.
(4) La délégation visée au paragraphe (3) est assujettie
aux conditions ou restrictions énoncées dans le règlement
administratif.
(5) Section 11 of the Act is repealed and the following substituted:
(5) L’article 11 de la Loi est abrogé et remplacé par
ce qui suit :
No personal liability
Immunité
11. (1) No action or other proceeding for damages
may be instituted against any member, officer, employee
or agent of the Council, or a member of a committee established under the by-laws of the Council for any act
done in the execution or intended execution in good faith
of the person’s function or duty under this Act or the regulations or for any alleged neglect or default in the execution in good faith of the person’s function or duty.
11. (1) Sont irrecevables les actions ou autres instances en dommages-intérêts introduites contre un
membre, un dirigeant, un employé ou un mandataire du
Conseil, ou un membre d’un comité créé en vertu des
règlements administratifs du Conseil, pour un acte accompli de bonne foi dans l’exercice effectif ou censé tel
des attributions que lui attribuent la présente loi ou les
règlements ou pour une négligence ou un manquement
qu’il aurait commis dans l’exercice de bonne foi de ses
attributions.
Council remains liable
Le Conseil demeure responsable
(2) Subsection (1) does not relieve the Council of any
liability to which it would otherwise be subject in respect
of a cause of action arising from any act, neglect or default referred to in subsection (1).
(2) Le paragraphe (1) n’a pas pour effet de dégager le
Conseil de la responsabilité qu’il serait autrement tenu
d’assumer à l’égard d’une cause d’action découlant d’un
acte, d’une négligence ou d’un manquement visé au paragraphe (1).
No actions or proceedings against the Crown
Immunité de la Couronne
11.1 (1) No action or other proceeding for damages
may be instituted against the Crown, the Minister or any
person employed by the Crown for any act, neglect or
default by a person referred to in subsection 11 (1) or for
any act, neglect or default by the Council.
11.1 (1) Sont irrecevables les actions ou autres instances en dommages-intérêts introduites contre la Couronne, le ministre ou toute personne employée par la Couronne pour un acte, une négligence ou un manquement
commis par une personne visée au paragraphe 11 (1) ou
pour un acte, une négligence ou un manquement commis
par le Conseil.
Same
Idem
(2) Subsection (1) does not apply to a proceeding to
enforce against the Crown its obligations under a written
agreement under which the Crown expressly assumes
liability for the acts or omissions of the Council.
(2) Le paragraphe (1) ne s’applique pas aux instances
introduites pour exécuter contre la Couronne les obligations que lui impose une entente écrite aux termes de laquelle la Couronne engage expressément sa responsabilité
pour les actes ou omissions du Conseil.
Unpaid judgments against the Council
Jugements contre le Conseil
11.2 The Minister of Finance shall pay from the Consolidated Revenue Fund the amount of any judgment
against the Council that remains unpaid after the Council
has made all reasonable efforts, including liquidating its
assets, to pay the amount of the judgment.
11.2 Le ministre des Finances prélève sur le Trésor le
montant de tout jugement rendu contre le Conseil qui demeure impayé une fois que le Conseil a fait des efforts
raisonnables pour l’acquitter, notamment en liquidant ses
éléments d’actif.
(6) Subclause 12 (1) (a) (iii) of the Act is amended
by striking out “consumer” at the beginning and substituting “patient”.
(6) Le sous-alinéa 12 (1) a) (iii) de la Loi est modifié
par remplacement de «de la clientèle» par «des patients» à la fin du sous-alinéa.
(7) Clause 12 (1) (c) of the Act is repealed and the
(7) L’alinéa 12 (1) c) de la Loi est abrogé et remplacé par ce qui suit :
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(c) to promote health care that is supported by the best
available scientific evidence by,
c) promouvoir les soins de santé qu’appuient les meilleures preuves scientifiques disponibles :
(i) making recommendations to health care organizations and other entities on clinical care
standards
(i) en faisant des recommandations aux organismes de soins de santé et autres entités sur
les normes de soins cliniques,
(ii) making recommendations to the Minister
concerning,
(ii) en faisant des recommandations au ministre
concernant :
(A) the Government of Ontario’s provision
of funding for health care services and
medical devices, and
(A) l’offre, par le gouvernement de
l’Ontario, d’un financement au titre des
services de soins de santé et des dispositifs médicaux,
(B) clinical care standards and performance
measures relating to topics or areas that
the Minister may specify;
(B) les normes en matière de soins cliniques
et les mesures de rendement relatives
aux sujets ou domaines que précise le
ministre;
(8) Subsection 12 (4) of the Act is amended by striking out “subclause (1) (c) (ii)” at the end and substituting “clause (1) (c)”.
remplacement de «au sous-alinéa (1) c) (ii)» par «à
l’alinéa (1) c)» à la fin du paragraphe.
(9) Section 13 of the Act is repealed and the following substituted:
(9) L’article 13 de la Loi est abrogé et remplacé par
ce qui suit :
Reports
Rapports
13. (1) The Council shall deliver to the Minister,
13. (1) Le Conseil présente au ministre :
(a) a yearly report on the state of the health system in
Ontario, and
a) un rapport annuel sur l’état du système de santé en
Ontario;
(b) any other reports required by the Minister.
b) les autres rapports qu’exige le ministre.
Publication on website
Publication sur un site Web
(2) The Council shall publish any recommendation it
makes under clause 12 (1) (c) on its website.
(2) Le Conseil publie toute recommandation qu’il fait
en application de l’alinéa 12 (1) c) sur son site Web.
Tabling
Dépôt du rapport annuel
(3) The Minister shall table every yearly report under
this section in the Legislative Assembly within 30 days of
receiving it from the Council.
(3) Le ministre dépose chaque rapport annuel prévu au
présent article devant l’Assemblée législative au plus tard
30 jours après l’avoir reçu du Conseil.
Purpose of reporting
Objectifs des rapports
(4) The purpose of reporting under clause (1) (a) is to,
(4) Les rapports prévus à l’alinéa (1) a) sont rédigés
aux fins suivantes :
(a) encourage and promote an integrated, patient centred health system;
a) encourager et promouvoir un système de santé intégré et axé sur les patients;
(b) make the Ontario health system more transparent
and accountable;
b) accroître la transparence du système de santé de
l’Ontario et le responsabiliser davantage;
(c) track long-term progress in meeting Ontario’s
health goals and commitments; and
c) suivre les progrès à long terme accomplis en vue
d’atteindre les buts fixés et de tenir les engagements pris pour l’Ontario en matière de santé;
(d) help Ontarians to better understand their health
system.
d) aider la population ontarienne à mieux comprendre
son système de santé.
(10) The definition of “patient or former patient” in
subsection 13.1 (9) of the Act is amended as follows:
(10) La définition de «patient ou ancien patient» au
paragraphe 13.1 (9) de la Loi est modifiée comme
suit :
1. Par adjonction de l’alinéa suivant :
1. By adding the following clause:
(c.1) a person who receives or has received services
from a local health integration network, but only
with respect to matters described in clause (c.1) of
c.1) une personne qui reçoit ou a reçu des services d’un
réseau local d’intégration des services de santé,
mais uniquement à l’égard des questions visées à
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the definition of “health sector organization” in
section 1,
l’alinéa c.1) de la définition de «organisme du secteur de la santé» à l’article 1;
2. By striking out “(c) or (d)” in clause (e) and
substituting “(c), (c.1) or (d)”.
2. Par remplacement de «c) ou d)» par «c), c.1) ou
d)» à l’alinéa e).
(11) Subsection 13.2 (1) of the Act is amended by
striking out “A patient” at the beginning of the portion before clause (a) and substituting “Subject to any
prescribed limitations with respect to time, a patient”.
(11) Le paragraphe 13.2 (1) de la Loi est modifié
par remplacement de «Tout patient» par «Sous réserve des restrictions prescrites quant aux délais, tout
patient» au début du passage qui précède l’alinéa a).
(12) Subsections 13.7 (1) and (2) of the Act are repealed and the following substituted:
(12) Les paragraphes 13.7 (1) et (2) de la Loi sont
abrogés et remplacés par ce qui suit :
Immunity
Immunité
(1) No proceeding shall be commenced against the
patient ombudsman or any employee of the Council for
any act done or omitted in good faith in the execution or
intended execution of the patient ombudsman’s functions
under this Act.
(1) Sont irrecevables les instances introduites contre
l’ombudsman des patients ou un employé du Conseil pour
un acte accompli ou omis de bonne foi dans l’exercice
effectif ou censé tel des fonctions de l’ombudsman que lui
attribue la présente loi.
(13) Clause 16 (1) (d) of the Act is amended by
striking out “structure and legal status” at the end and
substituting “and structure”.
(13) L’alinéa 16 (1) d) de la Loi est modifié par
remplacement de «, la structure et le statut juridique»
par «et la structure».
(14) Clause 16 (1) (p) of the Act is repealed and the
(14) L’alinéa 16 (1) p) de la Loi est abrogé et remplacé par ce qui suit :
(p) governing the purposes for which the Council may
use its assets and revenues;
p) régir les fins pour lesquelles le Conseil peut utiliser
ses éléments d’actif et ses recettes;
(p.1) governing the Council’s ability to borrow or invest
funds and the Council’s management of financial
risks;
p.1) régir la capacité du Conseil à contracter des emprunts, faire des placements et gérer des risques financiers;
Health Insurance Act
Loi sur l’assurance-santé
38. Section 2 of the Health Insurance Act is amended by adding the following subsection:
38. L’article 2 de la Loi sur l’assurance-santé est
modifié par adjonction du paragraphe suivant :
LHIN as agent
RLISS en tant que mandataire
(2.1) The Minister may appoint a local health integration network within the meaning of the Local Health System Integration Act, 2006 as the Minister’s agent for the
purpose of carrying out any function, obligation or right
under an arrangement referred to in clause 2 (2) (a) of this
Act, and the network shall have all rights and obligations
of the Minister under such an arrangement to the extent
that the network has been appointed as the Minister’s
agent, despite any provision of such an arrangement. The
Minister shall give notice of the appointment of a network
as an agent of the Minister to any other parties to the arrangement.
(2.1) Le ministre peut constituer un réseau local
d’intégration des services de santé au sens de la Loi de
2006 sur l’intégration du système de santé local comme
son mandataire afin d’exercer toute fonction ou obligation
ou tout droit aux termes d’une entente prévue à l’alinéa 2
(2) a) de la présente loi. Le réseau détient l’ensemble des
droits et obligations du ministre aux termes d’une telle
entente dans la mesure où il a été constitué mandataire du
ministre, malgré toute disposition de l’entente. Le ministre donne avis de la constitution du réseau en tant que
son mandataire aux autres parties à l’entente.
Health Protection and Promotion Act
Loi sur la protection et la promotion de la santé
39. (1) Section 67 of the Health Protection and Promotion Act is amended by adding the following subsections:
39. (1) L’article 67 de la Loi sur la protection et la
promotion de la santé est modifié par adjonction des
paragraphes suivants :
Engagement with LHIN
Participation du RLISS
(5) The medical officer of health of a board of health
shall engage on issues relating to local health system
planning, funding and service delivery with the chief executive officer or chief executive officers of the local
health integration network or networks whose geographic
area or areas cover the health unit served by the board of
health.
(5) Le médecin-hygiéniste d’un conseil de santé fait
participer le ou les chefs de la direction du ou des réseaux
locaux d’intégration des services de santé dont la ou les
zones géographiques couvrent la circonscription sanitaire
qui est du ressort du conseil de santé à l’étude des questions liées à la planification et au financement du système
de santé local et à la prestation de services au sein du système.
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Delegation
Délégation
(6) A medical officer of health may only delegate his
or her responsibilities under subsection (5) to another
medical officer of health for a health unit within the relevant local health integration network, with the agreement
of that other medical officer of health.
(6) Le médecin-hygiéniste ne peut déléguer les responsabilités qui lui sont attribuées conformément au paragraphe (5) qu’à un autre médecin-hygiéniste d’une circonscription sanitaire se trouvant au sein du réseau local
d’intégration des services de santé pertinent, avec l’accord
de cet autre médecin-hygiéniste.
(2) Paragraph 2 of the definition of “health care
provider or health care entity” in subsection 77.7 (6) of
the Act is repealed and the following substituted
de soins de santé ou entité chargée de la fourniture de
soins de santé» au paragraphe 77.7 (6) de la Loi est
abrogée et remplacée par ce qui suit :
2. A service provider within the meaning of the Home
Care and Community Services Act, 1994 who provides a community service to which that Act applies.
2. Le fournisseur de services au sens de la Loi de
1994 sur les services de soins à domicile et les services communautaires qui fournit un service communautaire auquel s’applique cette loi.
the Act is repealed.
abrogée.
the Act is repealed and the following substituted:
abrogée et remplacée par ce qui suit :
5. A pharmacy within the meaning of the Drug and
Pharmacies Regulation Act.
5. Une pharmacie au sens de la Loi sur la réglementation des médicaments et des pharmacies.
(5) The definition of “health care provider or health
care entity” in subsection 77.7 (6) of the Act is amended by adding the following paragraph:
(5) La définition de «fournisseur de soins de santé
ou entité chargée de la fourniture de soins de santé» au
paragraphe 77.7 (6) de la Loi est modifiée par adjonction de la disposition suivante :
9.1 A local health integration network within the
meaning of the Local Health System Integration
Act, 2006.
9.1 Un réseau local d’intégration des services de santé
au sens de la Loi de 2006 sur l’intégration du système de santé local.
Home Care and Community Services Act, 1994
Loi de 1994 sur les services de soins à domicile et les services
communautaires
40. (1) Subsection 28 (2) of the Home Care and
Community Services Act, 1994 is repealed and the following substituted:
40. (1) Le paragraphe 28 (2) de la Loi de 1994 sur
les services de soins à domicile et les services communautaires est abrogé et remplacé par ce qui suit :
Rules for charges for other services
Règles applicables à la facturation d’autres services
(2) Subject to subsection (3), if an approved agency
provides or arranges the provision to a person of a homemaking or community support service in accordance with
the person’s plan of service, the approved agency may
require payment from the person for the service and may
accept a payment made by or on behalf of the person for
the service.
(2) Sous réserve du paragraphe (3), si l’organisme
agréé fournit ou fait en sorte que soit fourni un service
d’aides familiales ou un service de soutien communautaire à une personne, conformément au programme de
services de cette dernière, il peut exiger d’elle le paiement
du service et accepter un paiement effectué par elle ou par
quiconque agit en son nom pour le service.
LHINs providing services
Fourniture de services par le RLISS
(3) If a local health integration network provides or
arranges the provision to a person of a homemaking or
community support service in accordance with the person’s plan of service, the network shall not require payment from the person for the service and shall not accept
a payment made by or on behalf of the person for the service.
(3) Si un réseau local d’intégration des services de
santé fournit ou fait en sorte que soit fourni un service
d’aides familiales ou un service de soutien communautaire à une personne, conformément au programme de
services de cette dernière, il ne doit pas exiger d’elle le
paiement du service, ni accepter de paiement effectué par
elle ou par quiconque agit en son nom pour le service.
Part:
(2) La Loi est modifiée par adjonction de la partie
suivante :
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PART VII.1
PROVISION OF COMMUNITY SERVICES
BY LOCAL HEALTH INTEGRATION NETWORKS
PARTIE VII.1
FOURNITURE DE SERVICES COMMUNAUTAIRES
PAR LE RÉSEAU LOCAL D’INTÉGRATION
DES SERVICES DE SANTÉ
Provision of community services
Fourniture d’un service communautaire
28.1 (1) Despite subsection 5 (1), the Minister may
approve a local health integration network to provide a
community service for the residents of the geographic
area of the local health integration network.
28.1 (1) Malgré le paragraphe 5 (1), le ministre peut
agréer un réseau local d’intégration des services de santé
aux fins de la fourniture d’un service communautaire aux
résidents de la zone géographique qui est de son ressort.
Effective date of approval
Date de prise d’effet de l’agrément
(2) If the Minister so specifies, an approval under subsection (1) shall be deemed to have taken effect on a day
fixed by the Minister that is before the day on which the
approval is given.
(2) Si le ministre le précise, l’agrément qu’il donne en
vertu du paragraphe (1) est réputé avoir pris effet le jour
fixé par le ministre, lequel est antérieur au jour où
l’agrément est donné.
Terms and conditions
Conditions
28.2 The Minister may impose terms and conditions on
an approval given under subsection 28.1 (1) and may
from time to time amend or remove the terms and conditions or impose new terms and conditions.
28.2 Le ministre peut assortir de conditions l’agrément
qu’il donne en vertu du paragraphe 28.1 (1) et peut, de
temps à autre, modifier ou supprimer ces conditions ou en
imposer de nouvelles.
Funding, etc.
Financement
28.3 (1) If the Minister approves a local health integration network to provide a community service under
section 28.1, the Minister may,
28.3 (1) Si le ministre agrée un réseau local
d’intégration des services de santé aux fins de la fourniture de services communautaires en vertu de l’article 28.1,
il peut :
(a) fund the local health integration network for the
purpose of providing community services and set
terms and conditions with respect to such funding;
and
a) accorder un financement au réseau local
d’intégration des services de santé aux fins de la
fourniture de services communautaires et en fixer
les conditions;
(b) enter into an agreement with the local health integration network for the purpose of providing community services.
b) conclure avec le réseau local d’intégration des services de santé une entente aux fins de la fourniture
d’un service communautaire.
Deemed accountability agreement
Entente de responsabilisation présumée
(2) An agreement entered into under subsection (1) is
deemed to be an accountability agreement for the purposes of section 18 of the Local Health System Integration
Act, 2006.
(2) L’entente conclue en application du paragraphe (1)
est réputée une entente de responsabilisation pour
l’application de l’article 18 de la Loi de 2006 sur
l’intégration du système de santé local.
Application of Act to LHIN providing community services
Application de la Loi à la fourniture de service communautaire par
le RLISS
28.4 (1) When a local health integration network provides a community service as approved by the Minister
under subsection 28.1 (1), the network is deemed to be an
approved agency or service provider, as the case may be,
for the purpose of this Act and the regulations under this
Act, and the network shall provide the services in accordance with this Act and the regulations under this Act
except that the following provisions of this Act and the
regulations that apply under those sections do not apply to
a network:
28.4 (1) Si un réseau local d’intégration des services
de santé fournit un service communautaire conformément
à l’agrément prévu au paragraphe 28.1 (1), il est réputé un
organisme agréé ou un fournisseur de services, selon le
cas, pour l’application de la présente loi et des règlements
pris en vertu de celle-ci, et il fournit les services conformément à la présente loi et aux règlements pris en vertu
de celle-ci. Toutefois, les dispositions suivantes de la présente loi et les règlements qui s’appliquent en vertu de ces
articles ne s’appliquent pas au réseau :
1. Sections 19, 20, 21.
1. Les articles 19, 20 et 21.
2. Clause 25 (2) (e) and subsection 25 (5).
2. L’alinéa 25 (2) e) et le paragraphe 25 (5).
3. Clause 31 (b).
3. L’alinéa 31 b).
4. Part X (other than subsection 56 (1)).
4. La partie X (à l’exception du paragraphe 56 (1)).
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Clarification
Précision
(2) For greater clarity, a local health integration network is deemed to be an approved agency and not a service provider for the purposes of clauses 25 (2) (a) and
(b), subsection 26 (1) and section 29.
(2) Il est entendu qu’un réseau local d’intégration des
services de santé est réputé un organisme agréé et non un
fournisseur de services pour l’application des alinéas 25
(2) a) et b), du paragraphe 26 (1) et de l’article 29.
Funding by LHINs
Financement par le RLISS
28.5 (1) The Minister may approve a local health integration network to provide funding to or on behalf of a
person to purchase a prescribed community service in
accordance with this section.
28.5 (1) Le ministre peut agréer un réseau local
d’intégration des services de santé pour qu’il accorde un
financement à une personne ou à quiconque agit en son
nom pour acheter un service communautaire prescrit conformément au présent article.
Effective date of approval
Date de prise d’effet de l’agrément
(2) If the Minister so specifies, an approval under subsection (1) shall be deemed to have taken effect on a day
fixed by the Minister that is before the day on which the
approval is given.
(2) Si le ministre le précise, l’agrément qu’il donne en
vertu du paragraphe (1) est réputé avoir pris effet le jour
fixé par le ministre, lequel est antérieur au jour où
l’agrément est donné.
Terms and conditions of approval
Conditions de l’agrément
(3) The Minister may impose terms and conditions on
an approval given under subsection (1) and may from
time to time amend or remove the terms and conditions or
impose new terms and conditions.
(3) Le ministre peut assortir de conditions l’agrément
qu’il donne en vertu du paragraphe (1) et peut, de temps à
autre, modifier ou supprimer ces conditions ou en imposer
de nouvelles.
Requirements
Exigences
(4) The following requirements apply with respect to
funding provided by a local health integration network
pursuant to an approval given under subsection (1):
(4) Les exigences suivantes s’appliquent à l’égard du
financement accordé par un réseau local d’intégration des
services de santé conformément à un agrément donné en
vertu du paragraphe (1) :
1. The network may only provide funding for those
community services that are prescribed.
1. Le réseau peut accorder un financement uniquement pour les services communautaires qui sont
prescrits.
2. Funding may only be provided for a person for
whom the network has developed a plan of service
under section 22.
2. Le financement peut être accordé uniquement à
l’égard d’une personne pour laquelle le réseau a
élaboré un programme de services en application
de l’article 22.
3. The person may apply to the network for the funding after the plan of service has been developed,
and the network may determine whether the person
is eligible for funding in accordance with the approval and the regulations, if any.
3. Après l’élaboration du programme de services, la
personne peut faire une demande de financement
au réseau. Celui-ci peut alors établir si la personne
est admissible au financement conformément à
l’agrément et aux règlements, le cas échéant.
4. If the network determines that the person is eligible
to receive funding, the network may provide the
funding based upon the person’s plan of service,
and in accordance with the approval and the regulations, if any.
4. S’il établit que la personne est admissible à recevoir un financement, le réseau peut accorder le financement à la personne en fonction de son programme de services et conformément à l’agrément
et aux règlements, le cas échéant.
5. The network shall, when it reviews and evaluates
the person’s plan of service under subsection 22
(2), make any revisions to the funding that are appropriate in consequence, and despite paragraph 7,
Part IX applies with respect to a decision by the
network respecting the amount of any community
services to be included in the person’s plan of service.
5. Après le réexamen et l’évaluation du programme
de services de la personne en application du paragraphe 22 (2), le réseau apporte au financement les
révisions appropriées qui résultent du réexamen et
de l’évaluation. Malgré la disposition 7, la partie
IX s’applique à l’égard d’une décision du réseau
relativement au montant de tout service communautaire à inclure dans le programme de services
de la personne.
6. The local health integration network may impose
terms and conditions on the funding provided to or
on behalf of the person to purchase the community
6. Le réseau local d’intégration des services de santé
peut imposer des conditions relativement au financement accordé à la personne ou à quiconque agit
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services set out in the person’s plan of service and
may from time to time amend or remove the terms
and conditions or impose new terms and conditions.
en son nom pour l’achat des services communautaires énoncés dans le programme de services de la
personne. Il peut, de temps à autre, modifier ou
supprimer ces conditions ou en imposer de nouvelles.
7. The other provisions of this Act, and the regulations made under this Act, do not apply to the network, other than,
7. Les autres dispositions de la présente loi et les règlements pris en vertu de celle-ci ne s’appliquent
pas au réseau, à l’exception de ce qui suit :
i. the definitions in Part II,
i. les définitions de la partie II,
ii. section 22,
ii. l’article 22,
iii. sections 59, 59.1, 64 and 66,
iii. les articles 59, 59.1, 64 et 66,
iv. the regulations made for the purposes of this
section,
iv. les règlements pris pour l’application du présent article,
v. any provisions of this Act or the regulations
that are made to apply by virtue of regulations
made for the purposes of this section.
v. les dispositions de la présente loi ou des règlements pris pour s’appliquer par l’effet des
règlements pris pour l’application du présent
article.
Protection from liability
Immunité
(5) No action or other proceeding for damages or otherwise, other than an application for judicial review under
the Judicial Review Procedure Act, shall be commenced
against the Crown, the Minister, a local health integration
network, any member, director or officer of a local health
integration network, or any person employed by the
Crown, the Minister or a local health integration network
with respect to any act done or omitted to be done or any
decision made under this section that is done in good faith
in the execution or intended execution of a power or duty
under this section.
(5) Sont irrecevables les actions ou autres instances,
notamment celles en dommages-intérêts, à l’exception des
requêtes en révision judiciaire présentées en vertu de la
Loi sur la procédure de révision judiciaire, qui sont introduites contre la Couronne, le ministre, un réseau local
d’intégration des services de santé ou un membre, administrateur ou dirigeant d’un tel réseau, ou quiconque est
employé par la Couronne, le ministre ou un tel réseau,
pour un acte qu’ils ont accompli ou omis d’accomplir ou
pour une décision qu’ils ont prise de bonne foi en vertu du
présent article dans l’exercice effectif ou censé tel des
pouvoirs ou des fonctions que leur attribue celui-ci.
(3) The definition of “approved services” in subsection 59 (1) of the Act is amended by adding “and includes services for which funding is provided under
section 28.5” at the end.
(3) La définition de «services approuvés» au paragraphe 59 (1) de la Loi est modifiée par insertion de
«S’entend en outre des services pour lesquels un financement est accordé en vertu de l’article 28.5.» à la
fin de la définition.
(4) Subsection 62 (2) of the Act is amended by adding “or section 28.3” after “clause 4 (c)” in the portion
before clause (a).
insertion de «ou de l’article 28.3» après «l’alinéa 4 c)»
dans le passage qui précède l’alinéa a).
(5) Paragraph 1 of subsection 64 (1) of the Act is
repealed and the following substituted:
(5) La disposition 1 du paragraphe 64 (1) de la Loi
est abrogée et remplacée par ce qui suit :
1. Ensuring compliance with this Act, the regulations,
an agreement made under clause 4 (c) or clause
28.3 (1) (b), a service accountability agreement
with a local health integration network or a term or
condition imposed by the Minister under this Act.
1. S’assurer de l’observation de la présente loi, des
règlements, d’une entente conclue en vertu de
l’alinéa 4 c) ou de l’alinéa 28.3 (1) b), d’une entente de responsabilisation en matière de services
conclue avec un réseau local d’intégration des services de santé ou d’une condition imposée par le
ministre en vertu de la présente loi.
(6) Subsection 68 (1) of the Act is amended by adding the following paragraphs:
adjonction des dispositions suivantes :
27.1 governing approvals, funding and related matters
for the purposes of section 28.5;
27.1 régir les agréments, le financement et les questions
connexes pour l’application de l’article 28.5;
27.2 prescribing the community services that may be
funded for the purposes of section 28.5;
27.2 prescrire les services communautaires qui peuvent
être financés pour l’application de l’article 28.5;
27.3 providing for additional provisions of this Act and
the regulations that apply to the provision of fund-
27.3 prévoir des dispositions supplémentaires de la présente loi et des règlements qui s’appliquent au fi-
110
ing under section 28.5, and clarifying the application of this Act and the regulations to such funding;
39
nancement accordé en vertu de l’article 28.5 et préciser l’application de la présente loi et des règlements à un tel financement;
Ministry of Health and Long-Term Care Act
Loi sur le ministère de la Santé et des Soins de longue durée
41. The Ministry of Health and Long-Term Care Act
is amended by adding the following section:
41. La Loi sur le ministère de la Santé et des Soins de
longue durée est modifiée par adjonction de l’article
suivant :
Patient and Family Advisory Council
Conseil consultatif patients-familles
10. The Minister may establish a Patient and Family
Advisory Council to provide patient perspectives and advice on strategic health policy priorities to the Minister.
10. Le ministre peut créer un conseil consultatif patients-familles chargé de lui présenter le point de vue des
patients et de lui fournir des conseils sur les priorités stratégiques en ce qui concerne les politiques en matière de
santé.
Ombudsman Act
Loi sur l’ombudsman
42. Section 13 of the Ombudsman Act is amended by
adding the following subsection:
42. L’article 13 de la Loi sur l’ombudsman est modifié par adjonction du paragraphe suivant :
Application to local health integration networks
Non-application aux réseaux locaux d’intégration des services de
santé
(9) This Act does not apply to local health integration
networks within the meaning of the Local Health System
Integration Act, 2006 with respect to matters described in
subclauses (c.1) (i), (ii) and (iii) of the definition of
“health sector organization” in section 1 of the Excellent
Care for All Act, 2010.
(9) La présente loi ne s’applique pas aux réseaux locaux d’intégration des services de santé au sens de la Loi
de 2006 sur l’intégration du système de santé locale à
l’égard des questions visées aux sous-alinéas c.1) (i), (ii)
et (iii) de la définition de «organisme du secteur de la
santé» à l’article 1 de la Loi de 2010 sur l’excellence des
soins pour tous.
Personal Health Information Protection Act, 2004
Loi de 2004 sur la protection des renseignements personnels sur la
santé
43. (1) Paragraph 3 of the definition of “health information custodian” in subsection 3 (1) of the Personal Health Information Protection Act, 2004 is repealed.
43. (1) La disposition 3 de la définition de «dépositaire de renseignements sur la santé» au paragraphe 3
(1) de la Loi de 2004 sur la protection des renseignements personnels sur la santé est abrogée.
(2) Paragraph 2 of subsection 3 (6) of the Act is repealed.
(2) La disposition 2 du paragraphe 3 (6) de la Loi
est abrogée.
(3) The Act is amended by striking out “paragraph
1, 2, 3 or 4 of the definition of “health information custodian”” wherever it appears in the following provisions and substituting in each case “paragraph 1, 2 or
4 of the definition of “health information custodian””:
(3) La Loi est modifiée par remplacement de «la
disposition 1, 2, 3 ou 4 de la définition de «dépositaire
de renseignements sur la santé»» par «la disposition 1,
2 ou 4 de la définition de «dépositaire de renseignements sur la santé»» partout où figure cette expression
dans les dispositions suivantes :
1. Subsections 20 (2) and (3).
1. Les paragraphes 20 (2) et (3).
2. Clause 38 (1) (a).
2. L’alinéa 38 (1) a).
3. Subclause 39 (1) (d) (i).
3. Le sous-alinéa 39 (1) d) (i).
Poverty Reduction Act, 2009
Loi de 2009 sur la réduction de la pauvreté
44. Clause 8 (1) (c) of the Poverty Reduction Act,
2009 is amended by striking out “community care access corporations”.
44. L’alinéa 8 (1) c) de la Loi de 2009 sur la réduction de la pauvreté est modifié par suppression de «les
sociétés d’accès aux soins communautaires,».
Private Hospitals Act
Loi sur les hôpitaux privés
45. (1) The Private Hospitals Act is amended by
adding the following section:
45. (1) La Loi sur les hôpitaux privés est modifiée
par adjonction de l’article suivant :
directives to a licensee of a private hospital where the
Minister considers it to be in the public interest to do so.
14.1 (1) Le ministre peut donner des directives opérationnelles ou en matière de politique au titulaire de permis
d’exploitation d’un hôpital privé s’il estime que l’intérêt
public le justifie.
111
40
Binding
(2) A licensee shall carry out every directive of the
Minister.
(2) Le titulaire de permis doit exécuter les directives du
ministre.
Portée
Law prevails
Primauté du droit
Public availability
(2) Section 15.3 of the Act is amended by striking
out “15.1 or 15.2” and substituting “14.1, 15.1 or
15.2”.
(2) L’article 15.3 de la Loi est modifié par remplacement de «15.1 ou 15.2» par «14.1, 15.1 ou 15.2».
(3) Clause 15.6 (a) of the Act is repealed and the
(3) L’alinéa 15.6 a) de la Loi est abrogé et remplacé
par ce qui suit :
(a) the issuing of a directive under section 14.1 or a
decision, revocation, termination or reduction under section 15.1 or 15.2; or
a) toute directive donnée en vertu de l’article 14.1 ou
toute décision prise ou toute révocation de permis
ou cessation ou réduction de paiements faite en
vertu de l’article 15.1 ou 15.2;
Public Hospitals Act
Loi sur les hôpitaux publics
46. (1) Section 8 of the Public Hospitals Act is
amended by adding the following subsections:
46. (1) L’article 8 de la Loi sur les hôpitaux publics
est modifié par adjonction des paragraphes suivants :
Disclosure
Divulgation
(5) The Minister shall make the report public.
(5) Le ministre met le rapport à la disposition du public.
(6) Before making the report public, the Minister shall
ensure that all personal health information in the report is
redacted.
(6) Avant de mettre un rapport à la disposition du public, le ministre veille à ce que tous les renseignements
personnels sur la santé qui y figurent soient retranchés.
section:
(2) La Loi est modifiée par adjonction de l’article
suivant :
directives to the board of a hospital where the Minister
considers it to be in the public interest to do so.
8.1 (1) Le ministre peut donner des directives opérationnelles ou en matière de politique au conseil d’un hôpital s’il estime que l’intérêt public le justifie.
Binding
(2) A board shall carry out every directive of the Minister.
(2) Le conseil doit exécuter les directives du ministre.
Portée
112
41
Law prevails
Primauté du droit
Public availability
following subsections:
des paragraphes suivants :
Disclosure
Divulgation
(9.1) The Minister shall make any report provided to
the Minister under subsection (9) public.
(9.1) Le ministre met tout rapport qui lui est remis en
application du paragraphe (9) à la disposition du public.
(9.2) Before making the report public, the Minister
shall ensure that all personal health information in the
report is redacted.
(4) Subsection 9.1 (2) of the Act is repealed and the
(9.2) Avant de mettre le rapport à la disposition du
public, le ministre veille à ce que tous les renseignements
(4) Le paragraphe 9.1 (2) de la Loi est abrogé et
remplacé par ce qui :
No proceeding against Crown
Immunité de la Couronne
(2) No proceeding, other than a proceeding referred to
in subsection 10 (2), shall be commenced against the
Crown or the Minister with respect to a decision or direction under section 5, 6 or 9, the issuing of a directive under section 8.1, the appointment of an investigator or a
hospital supervisor under section 8 or 9, the appointment
of an inspector under section 18 or any action or omission
of an investigator, hospital supervisor or inspector done in
good faith in the performance of a power or of an authority under any of those sections or under the regulations.
(2) Sont irrecevables les instances, autres que celles
visées au paragraphe 10 (2), introduites contre la Couronne ou le ministre à l’égard d’une décision, d’une directive ou d’un ordre visé à l’article 5, 6 ou 9, d’une directive
visée à l’article 8.1, de la nomination d’un enquêteur ou
du superviseur d’un hôpital visée à l’article 8 ou 9, de la
nomination d’un inspecteur visée à l’article 18 ou d’un
acte ou d’une omission commis de bonne foi par un enquêteur, le superviseur d’un hôpital ou un inspecteur dans
l’exercice d’un pouvoir conféré par l’un ou l’autre de ces
articles ou par les règlements.
(5) Le paragraphe 18 (4) de la Loi est abrogé et
Disclosure
Divulgation
(4) The Minister shall make any report provided to the
Minister under subsection (2) public.
(4) Le ministre met tout rapport qui lui est remis en
application du paragraphe (2) à la disposition du public.
(5) Before making a report public, the Minister shall
ensure that all personal health information in the report is
redacted.
(5) Avant de mettre un rapport à la disposition du public, le ministre veille à ce que tous les renseignements
Public Sector Labour Relations Transition Act, 1997
Loi de 1997 sur les relations de travail liées à la transition dans le
secteur public
47. The definition of “health services integration” in
section 2 of the Public Sector Labour Relations Transition Act, 1997 is amended by striking out “either” at
the end of the portion before clause (a), by striking out
“or” at the end of clause (a), by adding “or” at the end
of clause (b) and by adding the following clause:
47. La définition de «intégration des services de
santé» à l’article 2 de la Loi de 1997 sur les relations de
travail liées à la transition dans le secteur public est
modifiée par adjonction de l’alinéa suivant :
(c) a local health integration network;
c) soit un réseau local d’intégration des services de
santé.
113
42
Retirement Homes Act, 2010
Loi de 2010 sur les maisons de retraite
48. (1) Clause 54 (2) (p) of the Retirement Homes
Act, 2010 is repealed.
48. (1) L’alinéa 54 (2) p) de la Loi de 2010 sur les
maisons de retraite est abrogé.
(2) Subsection 54 (2) of the Act is amended by adding the following clause:
(p.1) contact information for the local health integration
network within the meaning of the Local Health
System Integration Act, 2006 for the geographic
area in which the retirement home is located;
p.1) les coordonnées du réseau local d’intégration des
services de santé au sens de la Loi de 2006 sur
l’intégration du système de santé local qui dessert
la zone géographique où est située la maison de retraite;
Smoke-Free Ontario Act
Loi favorisant un Ontario sans fumée
49. (1) Clause (a) of the definition of “home healthcare worker” in subsection 9.1 (5) of the Smoke-Free
Ontario Act is repealed.
49. (1) L’alinéa a) de la définition de «travailleur
de la santé à domicile» au paragraphe 9.1 (5) de la Loi
favorisant un Ontario sans fumée est abrogé.
(2) The definition of “home health-care worker” in
subsection 9.1 (5) of the Act is amended by adding the
following clause:
(2) La définition de «travailleur de la santé à domicile» au paragraphe 9.1 (5) de la Loi est modifiée par
(a.1) a local health integration network as defined in
section 2 of the Local Health System Integration
Act, 2006; or
a.1) soit un réseau local d’intégration des services de
santé au sens de l’article 2 de la Loi de 2006 sur
COMMENCEMENT AND SHORT TITLE
ENTRÉE EN VIGUEUR ET TITRE ABRÉGÉ
Commencement
Entrée en vigueur
50. (1) Subject to subsections (2), (3) and (4), this
Act comes into force on the day it receives Royal Assent.
50. (1) Sous réserve des paragraphes (2), (3) et (4),
la présente loi entre en vigueur le jour où elle reçoit la
sanction royale.
Same
Idem
(2) Subsections 37 (1) and (2) come into force on the
later of the day section 1 of Schedule 5 to the Public
Sector and MPP Accountability and Transparency Act,
2014 comes into force and the day this Act receives
Royal Assent.
(2) Les paragraphes 37 (1) et (2) entrent en vigueur
le dernier en date du jour de l’entrée en vigueur de
l’article 1 de l’annexe 5 de la Loi de 2014 sur la responsabilisation et la transparence du secteur public et des
députés et du jour où la présente loi reçoit la sanction
royale.
Same
Idem
(3) Subsections 37 (10), (11) and (12) and section 42
come into force on the later of the day section 4 of
Schedule 5 to the Public Sector and MPP Accountability and Transparency Act, 2014 comes into force and
the day this Act receives Royal Assent.
(3) Les paragraphes 37 (10), (11) et (12) et l’article
42 entrent en vigueur le dernier en date du jour de
l’entrée en vigueur de l’article 4 de l’annexe 5 de la
Loi de 2014 sur la responsabilisation et la transparence
du secteur public et des députés et du jour où la présente loi reçoit la sanction royale.
Same
Idem
(4) The following provisions of this Act come into
force on a day to be named by proclamation of the
Lieutenant Governor:
(4) Les dispositions suivantes de la présente loi entrent en vigueur le jour que le lieutenant-gouverneur
fixe par proclamation :
3. Section 19.
3. L’article 19.
4. Section 21.
4. L’article 21.
6. Section 31.
6. L’article 31.
7. Section 32.
7. L’article 32.
8. Section 34.
8. L’article 34.
114
12. Section 43.
12. L’article 43.
13. Section 44.
13. L’article 44.
43
Short title
Titre abrégé
51. The short title of this Act is the Patients First
Act, 2016.
51. Le titre abrégé de la présente loi est Loi de 2016
donnant la priorité aux patients.
115
BOARD OF DIRECTORS' MEETING - WED., JUNE 22, 2016 - STRATEGIC DIALOGUE
Briefing Note
Report to:
Central West LHIN Board of Directors
Agenda Number:
Item # 5.1
Subject:
Balanced Scorecard Spring/Year-End Cycle 2015/16
Purpose:
For Information
Date:
Wednesday, June 22, 2016
Key Contact:
Brock Hovey, Senior Director Health System Performance
Elizabeth Salvaterra, Director Decision Support
Recommended Motion: N/A
Background Summary :
Please find attached the Spring/Year-End Cycle 15/16 Central West LHIN Balanced Scorecard Dashboard.
Indicators requiring investigation this cycle included the following:
#2 90th percentile ED length of stay for high acuity patients
#6 90th percentile wait time for CCAC in-home services from community setting
#10 Repeat unscheduled emergency visits for substance abuse conditions
#17 Percent of home care clients with complex needs who received their first personal support visit within 5 days of
authorization
#19 Proportion of wait time indicators achieving target
#22 Proportion of falls indicators achieving target
Indicators #2 and #10 were red for the last four quarters. Indicator #19 has been red in every quarter since July 2013.
Indicator #6 is red for the first time since Q2 14/15, but is green for the year-end.
Indicator #17 has been yellow for all reporting quarters available (Q1 13/14) and is red for the first time. It is yellow for the yearend.
Indicator #22 is red for the first time in nearly two years (since Q4 13/14), but is green for the year-end.
Details on the reasons for the performance and the initiatives underway are included in the attached dashboard.
Options Considered: N/A
116
Impact Analysis:
Alignment with Strategic Priorities
Improve access to Care
Stream Line Transitions and Navigation
Drive Quality and Value
Build on the Momentum
Governance Best Practice
Operational Excellence
Enterprise Risk
Implementation Plan: N/A
Attachments:
2013-2016 Central West LHIN BSC Dashboard – 2015 Spring/Year-End Cycle
2
117
2013-2016 Central West LHIN Balanced Scorecard Dashboard--2015/16 Winter Cycle
Fall
Winter
Spring
YTD/
final
Measures
Actual
Summer
Target
2015-16
≤
≤
≤
≤
≤
≤
≥
4 hours
8 hours
9.46 %
TBD days
TBD days
21 days
TBD %
Q4 15/16
3.7
Q4 15/16
10.3
Q3 15/16
8.3%
Q2 15/16
17.0
Q2 15/16
21.0
Q3 15/16
18.0
10/14-09/15 86.4%
3.7
10.2
5.6%
8.0
15.0
16.0
85.7%
3.5
10.8
6.5%
11.0
14.0
19.0
84.4%
3.8
11.3
6.1%
13.5
20
31.0
80.9%
3.7
10.6
6.0%
12.0
16.0
21.0
N/A
≤
≤
≤
≤
≤
≤
≤
≤
1.2 per 1,000 population
16.3 %
22.4 %
TBD per 100,000 population
157 per 100,000 population
69.8 per 100,000 population
15.5 %
12.7 %
Q3 15/16
Q3 15/16
Q3 15/16
Q3 15/16
Q3 15/16
Q3 15/16
Q2 15/16
Q4 15/16
1.3
15.8%
26.0%
462
143.7
67.4
14.8%
5.9%
1.2
15.0%
29.5%
490
148.7
68.7
15.5%
5.3%
1.1
14.1%
31.0%
468
139.8
68.8
16.2%
4.9%
1.1
17.4%
29.1%
506
168.5
69.3
15.6%
6.0%
3.5
15.6%
29.1%
481
150.2
208.0
16.0%
5.5%
≥
≥
≥
=
≥
=
=
≥
55 %
95 %
95 %
6/6 indicators
TBD %
3/3 indicators
2/2 indicators
TBD %
10/14-09/15
Q3 15/16
Q3 15/16
Q4 15/16
Q2 15/16
Q4 15/16
Q3 15/16
Q3 15/16
52.4%
93.3%
96.9%
0/6
53.0%
2/3
2/2
68.1%
53.8%
93.8%
96.6%
0/6
57.4%
2/3
2/2
87.4%
50.6%
89.0%
95.8%
1/6
57.6%
3/3
2/2
87.8%
53.0%
83.6%
95.2%
0/6
54.2%
2/3
1/2
89.4%
53.0%
88.4%
95.9%
0/6
56.0%
2/3
2/2
N/A
≥
=
=
TBD %
TBD per 51 HSP's
TBD per 51 HSP's
11/15-04/16 62.5%
Q4 15/16
33/51
Q4 15/16
37/51
63.4%
33/51
37/51
61.9%
33/51
37/51
64.3%
33/51
37/51
66.7%
33/51
37/51
=
=
100 %
100 %
March 31
March 31
Current
Period
LHIN Resident Experience
1. 90th percentile ED length of stay for low acuity patients
2. 90th percentile ED length of stay for high acuity patients
3. Percentage of ALC days experienced by patients discharged from acute inpatient hospital beds
4. CCAC wait times from application to eligibility determination for LTCH placements: from acute-care setting
5. CCAC wait times from application to eligibility determination for LTCH placements: from community setting
6. 90th percentile wait time for CCAC in-home services from community setting
7. Overall satisfaction with health care in the community
Value (Quality/$)
8. Rate of emergency visits for conditions best managed elsewhere
9. Repeat unscheduled emergency visits within 30 days for mental health conditions
10. Repeat unscheduled emergency visits within 30 days for substance abuse conditions
11. Rate of ED visits in youths for mental health and substance abuse conditions
12. Rate of unscheduled emergency visits for hyperglycemia or hypoglycemia
13. Hospitalization rate for ambulatory care sensitive conditions per 100,0000 population
14. Readmissions within 30 days for selected HBAM Inpatient Grouper (HIG) Conditions
15. ALC Rate (inpatient capacity lost to ALC)
System Performance
16. Proportion of residents with access to primary care by the next day
17. Percent of home care clients with complex needs who received their first personal support visit within 5 days of authorization
18. Percent of home care clients who received their first nursing visit within 5 days of authorization
19. Proportion of wait time indicators achieving target (6 MLAA indicators)
20. Percent of acute care patients who have had a follow-up with a physician within 7 days of discharge
21. Proportion of nosocomial infection indicators achieving target
22. Proportion of falls indicators achieving target
23. Percent of palliative care patients discharged from hospital with home support
Learning & Growth
24. % of eligible IAR organizations with active user accounts
25. Number of HSP's that are accredited
26. Number of HSP's that have Quality Improvement Plans that they have shared with the LHIN
Project Management
Percent IHSP projects on target
Percent base cycles on target
118
75.0%
100.0%
81.0%
92.0%
93.3%
90.9%
92%
91%
84.7%
93.2%
Legend
within target
not within target, but not of concern
not within target, and of concern
N/A
2013-2016 Central West LHIN Balanced Scorecard Dashboard--2015/16 Spring Cycle Drill Down
Measure
Target
2015-16
Current
Period
Performance
Initiatives
Commentary
LHIN Resident Experience
≤ 8 hours
Q4 15/16
11.3
≤ 8 hours
Year-End
15/16
10.6
2. 90th percentile
ED length of stay
for high acuity
patients
Initiatives addressing ED length of stay for complex patients are focused exclusively on Patient Experience
patients admitted to inpatient beds, as the experience of patients discharged home
In 2015/16, the Central West LHIN ranked eleventh out of fourteen LHINs for high
(the overwhelming majority) is well within the best practice target.
acuity emergency department length of stay (EDLOS), with 84% of complex patients
discharged from Central West LHIN emergency departments within the target of 8
ED length of stay for complex patients includes two patient cohorts, each of which has hours. At 10.57 hours for the year, Central West performance was just over half an
substantially different experiences in the emergency department. High acuity patients hour longer than provincial performance as a whole.
who are discharged from the ED spend the majority of their length of stay in value
added activities, such as assessment and treatment. Patients who are admitted to an Non-Admitted Patients
inpatient bed spend the vast majority of their length of stay simply waiting for an
Of the 212,181 patients in the complex category in the Central West LHIN for 2015/16,
impatient bed to become available (time to inpatient bed). Combining these two groups 180,439 (85%) were discharged home from the ED. 90th percentile (90P) EDLOS for
masks the very poor experience of the latter group.
these patients was 7.1 hours, with 93% being discharged within the target of 8 hours.
EDLOS at the 50th percentile (median) was 3.3 hours. Patients in this category are not
spending excessive time in Central West LHIN emergency departments.
Barriers to discharge from the ED have largely to do with inpatient capacity. Most
patients occupying hospital beds in the Central West LHIN are not designated ALC,
and the LHIN also has one of the shortest acute lengths of stay in the province.
Patients occupying hospital inpatient beds in large measure need to be there.
≤ 8 hours
Q4 15/16
47.3
2a. 90th Percentile
ED length of stay
for admitted
patients
≤ 8 hours
Year-End
15/16
Multiple providers have initiatives in place that are intended to reduce ED visits for
vulnerable patients, prevent admission to an inpatient bed where possible and
streamline it when unavoidable, prevent ALC designation, and increase capacity both
inside and outside of the hospital--all these interventions will decrease the LOS
experienced by admitted patients. However, the greatest issue is that there is simply
more demand for acute hospital beds than there is supply.
35.7
≤ 21 days
Q3 15/16
31.0
≤ 21 days
Year-to-date
Q1-Q3 15/16
21.0
6. 90th percentile
wait time for CCAC
in-home services
from community
setting
The escalating rate of referral volumes is fast outstripping the availability of funding to
support higher volumes within the limitations of the Central West CCAC budget. As
patients are prioritized and triaged by complexity and service type, and an increasing
number of patients are waitlisted for services (with the exception of those referred for
nursing support), waitlists grow. As the number of patients on the waitlist grows, so
does the number of days waiting. When patients are removed from the waitlist, their
cumulative days waiting factor into the performance calculation for this indicator. As
long as escalating demand continues to outstrip available services as per funded
levels of activity, the Central West CCAC will continue to implement strategies to
manage volumes "at the door" including waitlisting and performance on this indicator
will be variable and vulnerable to further decline.
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119
Performance for admitted patients in 2015/16 was as follows:
Volume
% within 8 hrs
90P
50P
BCH 17,587
28%
49.7 hrs
12.2 hrs
EGH 10,960
36%
48.7 hrs
10.5 hrs
HHCC 3,195
77%
13.3 hrs
5.8 hrs
LHIN 31,742
36%
35.7 hrs
10.5 hrs
Time to Decision
The maximum amount of time that any patient should spend in the ED is 8 hours. For
10% of patients, the time taken to make the decision to admit them was more than
10.7 hours.
Time to Inpatient Bed
This segment measures the time between the decision to admit and the patient being
transferred to the inpatient bed they need. 10% of patients waited more than 39.5
hours, meaning that 75% of the time that these patients spent in the emergency
department was wait time. At the 50th percentile, time to inpatient bed was only 5.3
hours, indicating that performance is strongly influenced by the very long wait times
experienced by a small number of patients.
From October - December 2015, 1,799 clients were served with a 90th percentile wait
time of 31 days. The Central West missed the provincial target by 10 days and
performed worse (longer) than provincial performance of 29 days.
For the fiscal year, the Central West LHIN met the provincial target and performance
was better (shorter) than the province by 9 days.
Measure
Target
2015-16
Current
Period
Performance
Initiatives
Commentary
The LHIN met with InSTED partners SHIP - Supportive Housing in Peel, Punjabi
Community Health Services and Canadian Mental Health Association Peel Branch to
discuss the 1-year program review report. Partners highlighted where the program was
not adhering to the model as they anticipated although the program is achieving good
outcomes for clients. Program documentation will be revised to reflect actual operating
practices. Partners are also asked to better reflect the impact of all aspects of the
program, in particular the strategy to support clients while they wait for longer-term
clinical support. LHIN staff will continue discussions with the partners to ensure
service quality, including equitable access to short-term support.
From October-December 2015, LHIN performance was 29.1%, above (worse) both the
baseline (26.1%) and the provincial target (22.4%).
The Central West CCAC engages in a "Care Within Funding" leadership discussion
biweekly to proactively develop a response to changing pressures and new infusions of
funds as immediately as possible and continually tweak service allocation strategies to
ensure care plans are as efficiently conservative as possible, and the highest risk
patients are prioritized.
In Q3 2015/2016, the CCAC admitted (to service or waitlist) more than double the
number of PSW patients as in the same quarter in 2014/15 (average of 298 a month
versus 138 a month), while nursing referrals increased somewhat from an average of
800 a month admitted to an average of 870 a month. Increased referral volumes were
from both the community and the acute sector.
Value (Quality/$)
≤ 22.4%
Q3 15/16
29.1%
≤ 22.4%
Year-to-date
Q1-Q3 15/16
29.1%
10. Repeat
unscheduled
emergency visits
within 30 days for
substance abuse
conditions
In this period, there were 832 total ED visits in the Central West LHIN for substance
abuse conditions. 242 of those visits were repeat visits, made by a total of 116 people.
The InSTED program at William Osler Health System from April to December 2015
served 166 substance abuse clients and repeat visits totaled 166 for the 30 days prior
to engagement with InSTED. In the 30 days after service from the program, repeat
visits were reduced by 59% to 68 visits. The program exceeded the annual target of
clients served, by 38% in the first three quarters. Of note, the annual capacity of
In addition to the InSTED program, the LHIN is working in collaboration with addiction InSTED is 500 mental health and addiction clients. Capacity is a significant issue as
services providers to identify interventions to address more specific reasons for alcohol the number of unique patients visiting the ED is growing. Over the last year, the
visits (e.g. withdrawal). Identification of consistently high users i.e. repeat visits is
number of unique patients with visits is up 22% having increased over each quarter
required and providers are working together to ensure that this is done. Further, a
from 529, to 617, to 630, and in Q3, to 644.
GTA LHIN review of mental health and addiction crisis services includes assessing
opportunities to improve the use of residential withdrawal management centres as a
Consistently, for 75% of the ED visits for substance abuse, the substance in question
site for substance abuse crisis intervention. LHIN Senior Directors are in the process is alcohol, a legal substance for which there is no provincial strategy targeting abuse.
of reviewing the final report from LHIN Leads for Mental Health and Addictions.
System Performance
17. Percent of
home care clients
with complex
needs who
received their first
personal support
visit within 5 days
of authorization
≥ 95%
Q3 15/16
83.6%
≥ 95%
Year-to-date
Q1-Q3 15/16
88.4%
The organization, at this point in time, prioritizes the provision of nursing services over
PSW services. That is, within finite resources an increasing proportion of dollars is
being allocated to a proportionally high volume of nursing patients, who are not
waitlisted, forcing increased waitlisting of patients waiting for Personal Support
Services to offset the costs. The decision to prioritize allocation of available resources
to nursing before Personal Support Services is informed by ethical decision making
practices, management of clinical risk, the immediate system impact that would be
triggered if nursing patients were declined service, and the availability of alternative
options to patients and families.
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120
Measure
Target
2015-16
Current
Period
Performance
19. Proportion of
wait time indicators
achieving target
6/6
Q4 15/16
Year-End
0/6
19a. Proportion of
achieving target:
Percent of Priority
II-IV Cancer
Surgeries
Completed within
access target days
(PII - 14, PIII - 28,
PIV - 84)
Initiatives
For the 2015/16 year, changes have been made to the wait times indicators in the MLAA. Cancer and Cataract surgeries have been moved from the accountability section to
the monitoring section, and % within target is now measured for all but the highest priority patients, rather than only the lowest priority, as in the past two years.
Please see specifics of strategies and performance explanation below:
≥ 90%
≥ 90%
Q4 15/16
Year-End
15/16
87.5%
88.6%
The decentralized booking process with the respective surgeons' offices responsible
for booking appointments at Osler allows for improved wait time monitoring. Active
monitoring has assisted in the adjustment of OR blocks and resource allocation, as
required, to enhance access to surgery. In addition, the hospital's surgical program has
established a team to monitor performance and provide recommendations to
Surgeons' Offices to improve the quality of wait list records. The team also introduced
new OR schedules in FY 2015/16 to ensure that there is adquate OR capacity to
perform oncology procedures.
Percent of Priority
II-IV Cataract
Surgeries
completed within
access target days
(PII - 42, PIII - 84,
PIV - 182)
≥ 90%
≥ 90%
Q4 15/16
Year-End
15/16
88.8%
87.1%
The LHIN is within 10% of the provincial access target in Q4 15/16, ranking sixth out of
14 LHIN's. Performance was nearly 1 percentage point better (higher) than provincial
performance.
Performance for the fiscal year was 1.4% below target, but 0.5 percentage points
better than provincial performance.
Local performance in Q4 was as follows:
Volume
% within access days
BCH
261
84%
EGH
111
95%
HHCC
11
91%
Headwaters Health Care Centre has begun implementing the recommendations of its
surgical process improvement project which was initiated in Q1 15/16. The project
aims to increase efficiencies in OR time utilization and scheduling of OR blocks. The
implementation entails four streams of work which are: governance, OR block
utilization, model of care changes and supply chain opportunities.
19b. Proportion of
achieving target:
Commentary
The hospital is also working on several rapid cycle improvements, including turn
around times and cancellations. Headwater is also adding a fourth OR as part of its
redevelopment project.
Based on discussions initiated by the LHIN with Osler and Cancer Care Ontario, the
two organziations are collaborating to review and audit surgical wait lists at Osler to
accurately reflect demand by identifying any open cases that should be removed. One
of the goals of the project is to close open cases that are no longer valid. As part of ongoing maintenannce, the project requires Osler to establish a process to validate and
attest to the accuracy of wait lists by wait time priority, confirm that Surgeons' Offices
are using the correct wait list entry codes and identify open cases that are outliers and
determine follow up actions with Surgeons' Offices. The project is expected to
conclude by July 30, 2016.
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121
The LHIN is below the provincial access target in Q4 15/16, by 1.2 percentage points,
ranking seventh out of 14 LHINs, and performing 1.4 percentage points better than the
province as a whole. Performance for the fiscal year was 3.0 percentage points below
target and 1 percentage points worse (lower) than provincial performance. The year
end volumes of cataract surgeries performed is at 108.7% and 100.2% of funded
volumes for Headwaters and Osler, respectively - Headwaters and Osler performed 47
and 12 more cases, respectively, than the funding allocation for the fiscal year.
Measure
19c. Proportion of
achieving target:
Percent of Priority
II-IV Hip
Replacement
Surgeries
completed within
access target days
(PII - 42, PIII - 84,
PIV - 182)
Target
2015-16
Current
Period
Performance
≥ 90%
Q4 15/16
71.8%
≥ 90%
Year-End
15/16
67.5%
Initiatives
Commentary
The musculoskeletal (MSK) clinic at Osler assesses patients' treatment requirements Hip: The LHIN ranked tenth out of 14 LHINs in Q4. Performance for the fiscal year was
to determine referrals to surgeons. The goal of the MSK clinic is to achieve efficiencies 18.2% below target and 7.9 percentage points worse (lower) than provincial
for wait time targets through efficient and timely assessments. The MSK clinic is
performance.
aligned with provincial guidelines.
Osler completed more hip replacement surgeries than were added to the waitlist in Q4.
Osler's complex integration wait time reporting standard has improved wait time
There were 178 priority II-IV patients on the waitlist at the beginning of Q4, and another
reporting accuracy. The efficient management of "surrendered" OR blocks and
78 were added to the waitlist during the quarter. 85 Priority II-IV surgeries were
scheduling the OR three months in advance have contributed to improvements and
completed in this period, 33% of the total waitlist of 256.
better planning of OR utilization times, with priority given to surgeons who are below
target in terms of volume.
The year end volumes of hip replacement surgeries performed is at 103% of funded
volumes - Osler completed 9 more cases than was allocated for the fiscal year.
As previously noted in indicator 19b commentary, Osler and Cancer Care Ontario are
collaborating to review and audit surgical wait lists at Osler and is expected to conclude Knee: The LHIN ranked twelfth out of 14 LHINs in Q4. Performance has worsened
by July 30, 2016.
since last quarter, with performance 15 percentage points lower than in Q3 15/16.
Performance for the fiscal year was 22.5% below target and 6.8 percentage points
worse (lower) than provincial performance.
Osler completed more knee replacement surgeries than were added to the waitlist in
Q4, but the waitlist continues to grow. There were 826 Priority II-IV patients on the
waitlist at the beginning of Q4, and another 227 were added to the waitlist during the
quarter. 248 Priority II-IV surgeries were completed in this period, 24% of the total
waitlist of 1,053.
19d. Proportion of
achieving target:
Percent of Priority
II-IV Knee
Replacement
Surgeries
completed within
access target days
(PII - 42, PIII - 84,
PIV - 281)
The year end volumes of knee replacement surgeries performed is at 108% of funded
volumes - Osler completed 74 more cases than was allocated for the fiscal year.
≥ 90%
Q4 15/16
60.1%
≥ 90%
Year-End
15/16
72.2%
All efficiency measures suggested by the Ministry and by the LHIN have been
implemented, but demand for knee replacements continues to far outstrip supply.
Page 5 of 6
122
Measure
Target
2015-16
Current
Period
Performance
Initiatives
Osler continues to increase efficiencies, streamline booking processes and audit the
booking system to reduce the number of "no shows." The hospital continues to adjust
operational hours to increase throughput. As part of this adjustment, one magnet at
each hospital has been operational 24x7 since FY 2015/16.
19e. Proportion of
achieving target:
Percent of Priority
II-IV MRI scans
completed within
access target days
(2, 10, 28)
≥ 90%
≥ 90%
Q4 15/16
Year-End
15/16
33.4%
In order to manage an increase in ER and inpatient referrals, inpatient appointments
were created. Beginning in FY 2015/16, inpatient weekend scans are available at both
hospital sites to manage demand and improve performance for inpatient wait times. A
process to assess MRI requests for appropriateness through radiologist protocolling
was also implemented.
Percent of Priority
II-IV CT Scans
Completed within
access target days
(2, 10, 28)
22. Proportion of
falls indicators
achieving target
Rate of in-hospital
fractures in Central
West facilities per
100,000 inpatient
days
≥ 90%
≥ 90%
Q4 15/16
Year-End
15/16
From 2010 to 2014, Osler's MRI volumes increased by 48%, slightly higher than the
average provincial increase of 46%. The hospital performed 35,019 PII-PIV scans in
FY 2015/16, an increase of over 15% from last year's volumes.
There was a reduction of one FTE, effective April 1, 2016. This will result in a reduction
of nearly 10 appointments per week. Based on this, and demand factors, no
improvement in performance is anticipated.
33.3%
Osler continues to engage in workflow and throughput engineering by adjusting hours
of operation to meet demand, while Headwaters has added extra slots during the week
and on weekends to clear the backlog. Initiatives implemented at Headwaters, such as
educating staff on the priority levels and targets, have contributed to performance
improvements.
19f. Proportion of
achieving target:
Commentary
The LHIN ranked tenth out of 14 LHIN's in Q4, with performance similar to last
quarter's. Performance for the fiscal year was 56.7% below target and 5 percentage
points worse (lower) than provincial performance.
80.4%
71.5%
2/2
Q3 15/16
1/2
2/2
Q4 14/15 Q3 15/16
2/2
As part of the Extended Hours Project, staffing has been increased marginally at the
Etobicoke General Hospital site of Osler to manage demand, while five additional
appointments per day have been added to the roster at the Brampton Civic Hospital
site.
Local performance in Q4 was as follows:
Volume
% within access days
BCH
4,922
65%
EGH
3,909
97%
HHCC
925
94%
Osler and Headwaters are committed to preventing in-hospital fractures and falls. Both
hospitals have implemented a a rigorous falls prevention program that has been
recognized by Accreditation Canada as a leading practice to address the risks. The
comprehensive strategy includes a falls screen risk assessment tool, a falls scene
investigation process for post falls assessments, purposeful and frequent rounding,
instituting environmental safety measures such as exit alarm beds and appropriate use
of least restraint policies. The prevention programs aims are to promote a patientcentred environment supporting patient independence, establishes guidelines for the
prevention of falls and the standardized management of falls while maintaining the
safety of patients, families and staff members. Both hospitals have have mechanisms
for patient, family and staff education to reduce occurrences of falls.
The reasons for the fractures are multi-factorial--patients who fall are often confused
and despite having falls reduction strategies in place, they may still fall while in hospital
and suffer fractures. It is most unfortunate when falls result in a fracture and we treat
falls resulting in fractures as a learning opportunity to prevent recurrences in the future.
Project Management
Page 6 of 6
123
The LHIN ranked sixth out of 14 LHINs in Q4, performing 6 percentage points better
(higher) than the province as a whole. Performance for the fiscal year was 18.5%
below target and 3 percentage points worse (lower) than provincial performance.
Central West ranked ninth among all of the LHINs for the fiscal year..
The proportion of Priority II-IV CT scans completed within access target has improved
from the last three quarters.The LHIN’s performance is 9 percentage points better than
in Q3.
The number of scans completed has also increased. Central West LHIN hospitals
performed 36,414 PII-PIV CT scans in FY 2015/16, an increase of over 17% from the
last year's volumes.
In October - December 2015, a total of 7 patients suffered in-hospital fractures in a
Central West LHIN hospital - one at Headwaters, two at Etobicoke General and four at
Bramptom Civic. The rate of in-hospital fractures in Q3 15/16 was 10.5 per 100,000
inpatient days, above the provincial target of 10. This rate has not been above the
provincial target of 10 for nearly two years (since Q4 13/14).
For January 2015 - December 2015, the rate of in-hospital fractures in Central West
LHIN hospitals was 8.6 per 100,000 inpatient days and met the the provincial target.
Briefing Note
Report to:
Agenda Number:
Subject:
Purpose:
Date:
Key Contact(s):
Item # 5.2
2016/17 Q1 Enterprise Risk Management (ERM) Report
For Approval
June 22, 2016
Brock Hovey, Senior Director, Health System Performance,
Hyder Yusafzai, Specialist, Performance and Quality
Recommended Motion:
That the Central West LHIN Board of Directors approve the 2016/17 Q1 Enterprise Risk Management Report.
Background Summary:
Since FY 2013/14, the Central West LHIN has implemented ERM based on the application of a coordinated approach to the
completion of identified steps including: risk identification, assessment, mapping, planning, and, monitoring.
High Level Process for Updating Current Risks and Identifying New Risks
The LHIN has established a standardized process for on-going risk management and monitoring, identification of new risks
and quarterly reporting. Potential risks are ranked in terms of relative priority (the combination of impact of the risk occurring x
probability of the risk occurring).
Quarterly updates are received by the LHIN’s Operational Risk Manager (ORM) from the respective risk owners for their risks
and include information related to the status of the risk and the implementation of mitigation strategies. The Senior
Management Team (SMT) undertakes an in-depth review of all enterprise risks on a quarterly basis. Based on this, risks with
a relative priority ranking score of 8 and above are reported to the Board.
Risk Consolidation
The 2016/17 Q1 ERM Report is the ninth consolidated report being provided to the Board for approval on a quarterly basis.
The Report includes components from the following risk sources:
ß
ß
ß
Detailed Agency Risk Assessment Report which is submitted to the Ministry of Health and Long-Term Care
(MOHLTC). The updated Agency Risk Report was submitted to the MOHLTC on May 25, 2016, subsequent to
approval by the LHIN CEO
Quarterly Risk Summary, which is a component of the Quarterly Report submitted to the MOHLTC in Q1, Q2 and Q3.
There is no requirement to submit this report in Q4.
Central West LHIN’s ERM risk repository, reported on a quarterly basis (June, September, December and March of
each fiscal year).
124
2016/17 Q1 Quarterly Report to the MOHLTC
Risks that are being reported to the MOHLTC, as part of the Risk Summary for the 2016/17 Q1 Quarterly Report include the
following:
ß
ß
ß
ß
ß
Risk ID # 3: Increased ALC Days and/or ER visits for patients waiting for placement in Long-Term Care Homes (In
category of top risks)
Risk ID # 80: Maintenance of the Self – Reporting Initiative (SRI) System
Risk ID # 82: Home and Community Care Renewal
Risk ID # 83: Sustainability of United Achievers
Risk ID # 85: LHIN Board Member Turnover
Enterprise Risk Management 2016/17 Q1 Review – Status Update
All risks were reviewed in terms of risk decision (accept, mitigate, transfer and avoid), risk status (pending acceptance, open,
realized, expired), mitigation strategies, probable causes, contingency plans, triggers and scoring in terms of impact and
probability.
Key changes between Q4 (January to March 2016) and Q1 (April to June 2016) are highlighted below:
ß The number of risks has increased from 30 to 32
ß Two newly identified risks have been added in current reporting and are included in the category of top risks:
ÿ Risk ID # 83: Sustainability of United Achievers (priority ranking score of 8)
ÿ Risk ID # 85: LHIN Board Members Turnover (priority ranking score of 9)
ß The number of top risks reported to the Board has increased from 6 to 8 based on a reassessment of mitigation
strategies and priority rankings (see Attachment 1).
ß Risk decisions have changed between March and June 2016:
Risk Decision
March 2016
June 2016
Accept
5
4
Mitigate
25
28
Transfer
0
0
Avoid
0
0
TOTAL
30
32
Options Considered (if not applicable indicate N/A):
N/A
Impact Analysis (please check all that apply):
125
☐Alignment with Strategic
☐Build Integrated Networks of Care
☐Drive Quality and Value
☐Connect and Inform
☐Demonstrate System Leadership
☒Governance Best Practice
☒Operational Excellence
☒Enterprise Risk
Implementation Plan:
The ORM will continue to lead the ERM process to review existing risks and identify new risks in preparation for 2016/17 Q2
reporting to the Board.
Attachments:
ß
ß
ß
A summary diagram plotting the top 8 risks, as of June 2016, that were assigned a relative priority score of 8 or more
(representing risks that are considered high to medium impact and/or high to medium probability) and a corresponding list
of the top 8 risks including short risk description, colour-coded LHIN risk category, and the relative priority, impact and
probability scores for each risk (Attachment 1)
Risk Management Worksheets for the top 8 risks, with detailed information on description of the risk event,
mitigation/prevention options, probable causes, contingency plans and triggers (Attachment 2)
Two diagrams reflecting heat maps that highlight the number of risks associated with the relative priority scores (based
on impact x probability) and the changes between March and June 2016. Over time the objective is for risks to move
below the risk tolerance line on the heat map demonstrating effective mitigation strategies and contingency planning
(Attachment 3).
126
127
High
Attachment 1
Central West LHIN
Highest Scored Risks (“Top 8”) – June 2016
Relative
Priority =
Impact x
Probability
Impact
Score
Probability
Score
15
Access to health services locally is
limited due to availability of funding
that is unable to keep pace with the
demands and needs of an increasing
population.
12
3
4
82
In December 2015, the Ministry of
Health and Long-Term Care released a
discussion paper that calls for
fundamental structural change to the
CCAC system and proposes to
eliminate the Board and the
organization and embed the CCAC
functions within the LHIN. There is a
risk, should legislation be approved,
that during the transition period there
is an exodus of key governors, senior
leaders, and other staff that could
leave the organization vulnerable and
risk continuity of service delivery.
9
3
3
3
Access to long-term care is restricted
and system flow is impacted resulting
in an increase in ALC days for hospital
admitted patients waiting for LTCH
placement; and/or ER visit volumes
and/or admissions to hospital
increase from LTCH clients waiting in
the community for placement in
LTCH, increasing waiting list for LTCH
placement.
9
3
3
Operational
58
Lack of physician support for LHIN
initiatives (e.g. Health Links).
9
3
3
Financial
78
9
3
3
9
3
3
8
2
4
8
2
4
15
27
Ref ID
83
Risk Description
3.7
Probability
3
58
78
82
85
Low
Legend- Risk Category
Low
2.3
2.3
Impact
Reputational
3.7
High
85
Strategic
83
27
128
The Central West CCAC (CW CCAC) has
continued to prioritize clients based
on high acuity, which may result in
lower acuity clients not receiving
home care services. This can
potentially impact escalation of
hospital ED volumes a nd ALC days.
The LHIN Board of Directors has three
vacancies creating a challenge for the
Board as a whole to meet their
governance obligations with a
reduced number of appointed Board
members.
The viability of United Achievers as an
organization and provision of services
to its clients is at risk, as it has lost
temporary funding to support the
position of Executive Director.
Central West LHIN does not achieve
its Ministry LHIN Accountability
Agreement (MLAA) obligations.
Attachment 2
Risk Management Worksheets for the Top 8 Risks
129
130
Risk Management Worksheet
Table 1-Risk Management Worksheet
Risk Name: Increased ALC days and/or ER visits for
patients/clients waiting for placement in Long-Term
Care Homes (LTCHs)
Owner: B. Hovey + M. Edmonds
Risk Decision (accept, mitigate, transfer, avoid):
Mitigate
Description of the Risk Event:
Access to long-term care is restricted and system flow
is impacted resulting in an increase in ALC days for
hospital admitted patients waiting for LTCH placement;
and/or ER visit volumes and/or admissions to hospital
131
Risk ID #: 3
(Component of Q1 2016/17 Quarterly Report to
the MOHLTC)
Date Identified: September 2013
Date of Last Review:
ß November 31, 2013
ß February 27, 2014
ß May 16, 2014
ß August 21, 2014
ß May 22, 2015
ß August 21, 2015
ß October 6, 2015
ß May 11, 2016
Date of Last Revision:
ß March 12, 2014
ß September 10, 2014
ß June 5, 2015
ß August 21, 2015
Risk Status (pending acceptance, open,
realized, expired): Open
Mitigation/Prevention Options:
ÿ Reduce demand for Long-Term Care
(LTC) by increasing resources in
community-based programs such as
increase from LTCH clients waiting in the community
for placement in LTCH, increasing waiting list for LTCH
placement.
ÿ
ÿ
ÿ
ÿ
Probable Causes:
Contingency Plan(s):
ÿ High occupancy in LTCH and slower turnover
of LTCH beds.
There will be a temporary reduction in Central West’s
LTC bed capacity as a result of the City of Toronto’s –
Kipling Acres LTCH Redevelopment:
ß
ß
assisted living, day programs and home
care
When warranted, increase the number of
Assess and Restore and LTCH beds
dependant on capacity and funding to
implement
LHIN worked with the MOHLTC to
reallocate BIA funding to alternate
services that can mitigate the impact on
the temporary loss of LTCH capacity in
the community. The funding reallocation
has been aligned with the targeted
occupancy timeframe
Produce a multi-year redevelopment
plan for the eligible LTC homes in
keeping with the schedule developed by
the MOHLTC.
Develop a plan to maintain an
appropriate number of beds per 1000
population.
Phase 1 – 75 Beds in Abeyance (BIA) beds:
October 31, 2013 to December 31, 2015
Phase 2 – Additional 70 BIA beds (total 145
beds) to September, 2016.
ÿ Aging LTCH capital infrastructure, resulting in
less than desirable accommodations
ÿ Government policy not aligned with capacity
(e.g. people can wait until a bed becomes
2
132
ÿ Stem demand for LTC by increasing
capacity in community-based services
for seniors such as enhanced community
programming – wait at home/ stay at
home / home first, home care, assisted
living, and adult day programs
ÿ Creation of temporary LTCH beds in
Region of Peel Homes
ÿ Collaborative flow strategies working
with Central West HSPs
ÿ Creation of restorative care beds in
Brampton and Orangeville to reduce the
impact of temporary loss of capacity.
available in their preferred place, there are
empty beds in undesirable facilities)
ÿ Service pressures due to growth in the elderly
population
ÿ In January 2016, Kipling Acres informed the
LHIN of a delay in construction for Phase II.
Occupancy is set for September 2016 but the
programs funded by the BIA money will ramp
down in June 2016. This two month gap in
program availability may lead to an increase in
time to placement in LTC.
Probability & Impact: 9
Probability:3
Impact:3
Triggers:
ÿ ALC rates increase for hospital patients
waiting for LTCH placement
ÿ ER visit volume increases for clients
waiting for placement to LTCH
ÿ Admissions to acute services increase
for clients waiting for placement in LTCH
ÿ Ramp down of programs funded by BIA
may cause an increase in ALC rates.
ÿ Increase in time to placement and
waitlists, and reduced occupancy in
LTCH.
#3
3
133
Risk Name: Able to meet future needs of population
Owner: M. Edmonds
Mitigate
Access to health services locally is limited due to
availability of funding that is unable to keep pace
with the demands and needs of an increasing
population.
Risk ID #: 15
Date Identified: June 2013
ß May 16, 2014
ß August 21, 2014
ß May 22, 2015
ß August 28, 2015
ß November 6, 2015
ß May 11, 2016
ß August 21, 2014
ÿ Focus on reducing severity of the impact,
rather than on probability of occurrence
ÿ On-going efforts with MOHLTC to address
and improve historical underfunding, for
example, HBAM, HSFR, annual funding
increases
ÿ LHIN in partnership with local HSPs works
within annual planning cycles and processes
to address high needs and support high
impact initiatives to mitigate impact
134
ÿ Work with community and HSPs on
development of IHSP and annual planning
cycles
ÿ LHIN to continue advocacy for more
equitable funding / population based funding
ÿ Focus on promotion and prevention
strategies where able, to improve population
health
ÿ Based on IHSP strategic direction - Improve
Access to Care - catalogue services, monitor
utilization and analyze trends, determine
capacity, prioritize funding increases, seek
funding for areas of care that require
additional capacity, monitor best practices,
implement a system of health care
ÿ Focus increases in community-based
funding to MOHLTC and LHIN priorities to
improve and expand care in the community
ÿ Utilize community capacity study findings as
a tool for identifying and direction for
addressing local needs.
Probable Causes:
ÿ Very high population growth LHIN – population
growth far exceeding funding growth
ÿ Historical underfunding issue not being corrected
quickly enough
ÿ New funding models based on historical “base”,
funding and utilization
ÿ No MOHLTC appetite for “repatriation” in models –
bringing people closer to home – beyond new
funding models
ÿ May be data quality issues informing new funding
models
ÿ Seniors, though not high in numbers, have high
rate of growth and relatively high users of health
resources
ÿ Large number of births and large cohort of children
2
135
ÿ The LHIN continues to undertake in year
allocation/reallocation to address unforeseen
pressures that can be addressed to
maximize available resources
ÿ Where able, increase capacity in community
settings by providing additional funding for
in-home care
ÿ Stem demand for LTC by increasing capacity
in community-based services for seniors,
such as home care, assisted living housing,
and adult day programs.
ÿ Individuals "fall through the cracks" due to
insufficient services and navigation supports being
in place (mental health, addiction, seniors).
Probability: 4
Impact: 3
Triggers:
Longer waiting lists
Increased volumes of requests
Higher occupancy rates
Complaints and media reports
Longer waiting lists for services
ABP reporting identifies missed targets
Increased ALC days in acute care and
rehab beds
ÿ Increased use of ER.
ÿ
ÿ
ÿ
ÿ
ÿ
ÿ
ÿ
#15
3
136
Risk Name: Ministry LHIN Accountability Agreement
(MLAA) achievement
Owner: B. Hovey
Mitigate
Central West LHIN does not achieve its MLAA
obligations.
Risk ID #: 27
Date Identified: August 2013
ß June 9, 2014
ß March 2, 2015
ß June 2, 2015
ß March 7, 2016
ß May 24, 2016
ß June 9, 2014
ß June 2, 2015
ÿ Orientation of new Board and staff
members includes review of the MOU
and MLAA documents
ÿ Assure LHIN compliance declarations
are developed and approved, as
required
137
ÿ LHIN works with the MOHLTC to ensure
that realistic and achievable targets are
developed and finalized in a timely
manner
ÿ Assure quarterly meetings with the
MOHLTC on LHIN performance are
comprehensive and clearly identify
challenges, as well as accomplishments
ÿ Assure LHIN quarterly financial and risk
reporting to the MOHLTC is
comprehensive
ÿ Assure funding complies with MOHLTC
directives
ÿ Assure that the ABP reflects the IHSP
and aligns with major strategies within
the LHIN that meets the LHIN’s
obligation to manage the performance of
the local health system
ÿ Hold regular meetings with HSPs to
review performance and related targets
ÿ Annual audit of the LHIN
ÿ Work of the Central West LHIN Quality
Committee – establishing System Level
AIMS – linked to IHSP3 and MLAA
performance to drive improvement
ÿ Patient Flow and Wait Time initiatives
with Central West HSPs align and
monitor efforts to improve performance.
Probable Causes:
ÿ HSP financial and volumes forecasts
inaccurate
ÿ Unexpected financial and volumes pressures
lead to non-compliance
ÿ Performance obligations not met by HSPs
leading to MLAA targets not being met
ÿ MLAA targets not reflective of system
performance capability
2
138
ÿ Notify the MOHLTC in a timely manner
of a performance factor that may prevent
the LHIN from meeting its MOU / MLAA
obligations
ÿ If applicable, renegotiate financial and/or
performance requirements
ÿ Ensure that the LHIN Board has
understanding of factors leading to non-
ÿ LHIN’s internal systems not sufficient to meet
financial/performance and reporting
requirements
ÿ Delay in finalization of provincial Wait Time
Strategy allocations – not keeping pace with
demand.
compliance and degree to which the
LHIN can aid with improving
performance.
Triggers:
Probability: 4
Impact: 2
ÿ Forecasts of an unbalanced position
ÿ Performance failing to meet negotiated
targets (MLAA indicators)
ÿ Non-compliance with the terms of the
MLAA
ÿ MOHLTC notifies the LHIN of
outstanding obligations.
#27
3
139
Risk Name: Lack of physician support for LHIN
initiatives
Owner: M. Edmonds + D. Pearson
Risk ID #: 58
Mitigate
140
Date Identified: June 2013
ß June 9, 2014
ß May 22, 2015
ß August 28, 2015
ß November 6, 2015
ß May 11, 2016
ß December 10, 2013
ß March 21, 2014
ß June 19, 2014
ß May 22, 2015
ß August 28, 2015
ß November 6, 2015
ß May 11, 2016
Lack of physician support for LHIN initiatives (e.g.
Health Links).
ÿ Implement a managed growth model of
physician engagement / relationship
development
ÿ Continue to invest in local physician’s
development through initiatives like
Rotman Leadership Program offered by
the University of Toronto
ÿ Continue efforts to work with Ontario
Medical Association (OMA) and Ontario
College of Family Physicians (OCFP)
physician leaders
ÿ Support work of Primary Care Lead
ÿ Continue the work of the Primary Care
Network
ÿ As appropriate, revitalize the Health
Professionals Advisory Committee.
Probable Causes:
Physicians are not accountable to the LHIN
Perception of time commitment
Poor communications by LHIN
No remuneration for time and involvement
Government relations with physicians - no
OMA agreement, with physicians feeling
unvalued and dis-empowered, mounting legal
and media campaign
ÿ Attention associated with Patients First
discussion paper related to the LHIN’s
expanding role in primary care planning and
monitoring may provoke negative reactions in
some segments of physician community.
ÿ
ÿ
ÿ
ÿ
ÿ
Probability: 3
Impact: 3
ÿ Continue efforts to work with
OMA/OCFP physician and executive
leadership
ÿ “Go to them” approach. Don’t expect
physicians to come to the LHIN - the
LHIN will be nimble and go to them.
Triggers:
ÿ Inability to advance physician enabled
projects
2
141
ÿ Provincial OMA negotiations
ÿ Resignations/non-renewal of contracts
with existing physician leads.
#58
3
142
Risk Name: Central West CCAC Service Volume
Pressures
Owner: B. Hovey + T. George
Risk ID #: 78
Mitigate
Central West CCAC (CW CCAC) has continued to
prioritize clients based on high acuity, which may result
in lower acuity clients not receiving home care
services. This can potentially impact escalation of
hospital ED volumes and ALC days.
143
Date Identified: July 15, 2014
ß August 18, 2014
ß May 25, 2015
ß November 5, 2015
ß March 9, 2016
ß May 11, 2016
ß August 18, 2014
ß June 5, 2015
ß March 9, 2016
ÿ The LHIN brings the CW CCAC and the
hospitals together to develop mitigation
strategies to maintain system flow
ÿ The CW CCAC commits to balancing its
budget within the respective fiscal year
ÿ Based on a balanced budget position,
the CW CCAC develops an analysis of
client services and the associated
impact on the provision of these services
ÿ The Central West LHIN will continue to
work with the MOHLTC and the CW
CCAC to maximize the allocation of
additional funding
ÿ Ongoing communication strategies to
monitor impact
ÿ Appropriate allocation of additional
funds, when available.
Probable Causes:
ÿ Delay in funding announcements
ÿ High population growth rate in the Central
West LHIN
ÿ Increasingly complex and resource-intense
patients presenting for care
ÿ CW CCAC’s inability to align resources that
match demand in the respective fiscal year.
ÿ Early determination of annual funding to
CW CCAC, if any
ÿ LHIN staff will consider CW CCAC
pressures in the in-year reallocation
process.
Triggers:
Probability: 3
Impact: 3
ÿ Increase in patient referrals
ÿ Projected CW CCAC deficit
ÿ Other Health Service Providers inform
the LHIN that CW CCAC services are
not keeping pace with demand
ÿ Client complaint(s)
ÿ Client advocate/Ombudsman expresses
concern on behalf of a client
ÿ Increased ED visits from the community.
2
144
# 78
3
145
Risk Name: Maintenance of the Self – Reporting
Initiative (SRI) System
Owner: B. Hovey + Neil McIntosh
Accept
Performance management of Health Services
Providers (HSPs) is a core LHIN mandate. The
information used to assess performance and
adherence to volumes and targets specified in Service
Accountability Agreements entered into between the
LHINs and HSPs, is inputted and stored in the SRI
system - a MOHLTC purchased and directed system
which ensures all HSP information is commonly and
centrally available. The MOHLTC is responsible for the
146
Risk ID #: 80
the MOHLTC)
Date Identified: September 17, 2014
ß June 5, 2015
ß July 31, 2015
ß November 2, 2015
ß January 19, 2016
ß May 11, 2016
ß June 10, 2015
ß November 2, 2015
ÿ The MOHLTC adopt its full mandate as it
is related to the SRI system
ÿ If LHINs are required to adopt the
mandate as it relates to the SRI system,
then additional dedicated FTEs are
required
ÿ LHIN Senior Management work with the
MOHLTC to develop a feasible, mutually
acceptable sustainability plan.
maintenance of a central information system for both
the LHIN and its own use. LHIN's have participated in
the implementation of this system and have devoted
extensive staff time as an aid to its partners at the
MOHLTC, which has experienced internal staffing
adjustments and pressures. However, the current SRI
system and related HSP reporting process continues to
require LHINs to conduct extensive technical work to
create the submission forms and the technical
specifications documentation that accompany them this is the work for which LHIN staff do not have the
requisite technical expertise. Further, the related
workload is intensive. In this regard, the LHIN's have
not been staffed to deliver this support on a long-term
basis. The current approach is not likely to be
sustainable, with a significant risk to both the MOHLTC
and LHINs in terms of the ability to deliver adequately
on the mutual quarterly reporting and performance
management mandates, both from a local and
provincial perspective.
Probable Causes:
ÿ The MOHLTC has experienced internal
staffing adjustments and pressures and does
not have adequate capacity for SRI
maintenance
ÿ LHINs not staffed to deliver SRI related
support on a long-term basis.
Probability: 3
Impact: 2
ÿ Excel based quarterly financial and
statistical reporting to be submitted to
the LHIN by HSPs via email, with a copy
shared with the MOHLTC
ÿ Planning submissions related to various
sectoral SAAs to be submitted to the
LHIN via email, with a copy shared with
the MOHLTC.
Triggers:
ÿ SRI Functionality is compromised and
reports are corrupted, not saved or
inaccessible
2
147
ÿ HSP does not capture all funding and
volumes data in the lines appropriated in
the reporting
ÿ Templates may not be uploaded
correctly and/or SRI system is not
accessible due to technical issues
ÿ LHINs may be required to incorporate
corrections after the submission
deadline, resulting in delays.
# 80
3
148
Risk Name: Home and Community Care Renewal
Owner: S. McLeod
Mitigate
In December 2015, the Ministry of Health and LongTerm Care (MOHLTC) released a discussion paper
that calls for fundamental structural change to the
CCAC system and proposes to eliminate the Board
and the organization and embed the CCAC functions
within the LHIN. There is a risk, should legislation be
approved, that during the transition period there is an
exodus of key governors, senior leaders, and other
staff that could leave the organization vulnerable and
risk continuity of service delivery.
149
Risk ID #: 82
the MOHLTC)
Date Identified: February 8, 2016
ß March 7, 2016
ß
ÿ The LHIN has reached out to the Central
West CCAC (CW CCAC) at the Governance
and staff level to offer support and
assistance
ÿ The LHIN and the MOHLTC have
emphasized the importance of a strong
home and community care system and
provided assurances that all staff in
collective agreements will be protected and
there will be a smooth transition to the LHIN,
should legislation be approved
ÿ The LHIN Board and CW CCAC Board have
agreed to establish a joint Governance
Committee to oversee a smooth transition,
should legislation be approved
ÿ The MOHLTC will establish a provincial
transition team to oversee communications
and a smooth transition of enterprise wide
activities, subsequent to the passage of
proposed legislation
ÿ Once the direction is confirmed, based on
passage of proposed legislation, the LHIN
will establish a local transition team to
manage a smooth transition of staff into the
LHIN and begin working closely with CW
CCAC management
ÿ As soon as possible, subsequent to the
passage of proposed legislation, the LHIN
will provide key staff an understanding of the
process for transition into the new LHIN
organization and ideally with assurances
regarding their individual roles.
Probable Causes:
ÿ Governors, senior staff, and staff of the CW CCAC
are leaving because they do not see a future for
themselves at the organization or they do not
agree with the proposed change.
ÿ Development of a local communications
strategy for the public and for staff to provide
assurances that home and community care
services will not be impacted during the
transition
ÿ If governance oversight is of concern, then
the LHIN Board may assume greater
oversight during the transition
ÿ If there is a loss of key senior staff positions,
temporary / interim appointments could be
used to fill the gaps.
Probability: 3
Impact: 3
Triggers:
ÿ CW CCAC advises that they are losing key
individuals and/or are unable to recruit to key
positions
ÿ CW CCAC advises that Board members are
resigning or simply not engaging as part of
the Board.
2
150
#82
3
151
Risk Name: Sustainability of United Achievers
Owner: B. Hovey + N. McIntosh
Mitigate
The viability of United Achievers as an organization
and provision of services to its clients is at risk, as it
has lost temporary funding to the support the position
of Executive Director.
Probable Causes:
Risk ID #: 83
the MOHLTC)
Date Identified: May 13, 2016
ß May 13, 2016
ß
ÿ Implement enhanced monitoring/
reporting for United Achievers
ÿ Establish quality indicators as part of the
enhanced monitoring process
ÿ Implement regular meetings to discuss
performance and quality results.
ÿ Loss of funding support from the third party
funder.
Probability: 4
Impact: 2
ÿ Withdraw funding from United Achievers
and identify another suitable Health
Service Provider (HSP) to deliver
services currently being provided.
Triggers:
ÿ Departure of Executive Director from
United Achievers
ÿ Failure to submit regular financial reports
on a quarterly basis.
152
ÿ Inability to communicate with United
Achievers
ÿ A worsening financial position.
ÿ Failure to meet service volume targets
ÿ Non-compliance with MSAA obligations
and/or timelines.
# 83
2
153
Risk Name: LHIN Board Member Turnover
Owner: S. McLeod
Mitigate
The LHIN Board of Directors has 3 or more vacancies
creating a challenge for the Board as a whole to meet
their governance obligations with a reduced number of
appointed Board members.
Tenures of three members of the Central West LHIN
Board of Directors will be ending between June and
October 2016. The LHIN has initiated the process of
filling the resulting vacancies. However, based on
previous experience with the Public Appointments
Secretariat (PAS), appointments or reappointments of
Board Members do not happen in a timely way leaving
vacancies on the Board at any one time (3 or more).
Filling these vacancies is crucial to the efficient
governance of the LHIN from a strategic oversight
perspective, as departing Board members are either
Chairs or members of the following key committees:
ÿ Finance & Audit Committee
154
Risk ID #: 85
the MOHLTC)
Date Identified: May 17, 2016
ß May 17, 2016
ß May 24, 2016
ÿ The Board Governance Committee and
the Nominations Committee monitor
status of all Board Member
appointments on a regular basis
ÿ The Board through the CEO/Board
Liaison ensures that there are internal
processes in place to complete
submissions for appointment and
reappointment on a timely basis (at least
6 months in advance)
ÿ The Board Liaison establishes a strong
relationship with staff in the PAS to gain
insight into the process, understand
Central West LHIN submission status,
and advance issues as required
ÿ The Nominations committee works to
ensure appropriate recruitment
approaches for members based on
pending vacancies and the skills based
assessment of needs
ÿ CEO Performance Review & Compensation
Committee
ÿ Governance Committee
ÿ Quality Committee.
Probable Causes:
ÿ The Committee and the Chair maintain a
list of potential Board members who may
be worth considering.
ÿ Poor advance planning on the part of the LHIN
to initiate the process early enough
ÿ Delays on part of the PAS or the Ministers
office in processing of submissions from the
LHIN.
ÿ Challenges in recruitment of qualified Board
Members.
ÿ Delays resulting from the complex multi-level
review process before appointments are
finalized.
Probability: 3
Impact: 3
ÿ In the event of significant reduction in
the number of Board members, the
Chair and CEO would raise this issue as
a matter of urgent attention to the
MOHLTC / Minister’s office.
ÿ Where key gaps on committee’s occur,
the Chair, in collaboration with Board
Members would appoint members to
concurrent Board committees for an
interim period to ensure that LHIN
governance and oversight is not
impacted
ÿ If the number of Board members
becomes so low, the Board will operate
as a committee of the whole.
Triggers:
ÿ Board members terms of appointments
coming due and appointment process is
not seeming to progress
ÿ 3 or more vacant Board member
positions.
2
155
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3
156
Attachment 3
Central West LHIN Enterprise Risks – Changes in Relative Priority Rankings
Number of Risks by Relative Priority Before Risk Mitigation & Contingency
March 2016
PROBABILITY
IMPACT
1. Rare
2. Unlikely
3. Possible
4. Likely
Number of Risks by Relative Priority After Risk Mitigation & Contingency
June 2016
PROBABILITY
IMPACT
5. Almost
Certain
5. Extreme
5. Extreme
4. Significant
4. Significant
3. Moderate
3. Moderate
2. Minor
2. Minor
1.
Insignificant
Note: Cells contain the number of risks that received this ranking based on probability x impact
157
1. Rare
2. Unlikely
3. Possible
4. Likely
5. Almost
Certain
Briefing Note
Report to:
Agenda Number:
Subject:
Purpose:
Date:
Key Contact(s):
Item # 5.3
Annual Report 2015-2016 (AR 2015/16)
For Review and Approval
∑ Scott McLeod, CEO
∑ Mark Edmonds, Acting Senior Director,
Health System Integration
∑ Tom Miller, Director, Communications and
Community Engagement
Recommended Motion:
∑ That the Central West LHIN Board of Directors approve final draft of AR 2015/16.
Background Summary:
∑ An original draft of AR 2015/16 was presented to the Central West LHIN Board of Directors in May 2016.
∑ Edits and recommendations have since been received and incorporated.
∑ A final draft is now presented for review and approval.
∑ Submission deadlines to the Ministry of Health and Long-Term Care, LHIN Liaison Branch, are as
follows: English - June 30, 2016 and French – no later than August 31, 2016.
Impact Analysis (please check all that apply):
☐Alignment with Strategic Directions
☐Build Integrated Networks of Care
☐Drive Quality and Value
☐Connect and Inform
☐Demonstrate System Leadership
☐Governance Best Practice
☒Operational Excellence
☒Enterprise Risk
Implementation Plan:
∑ Following Board approval AR 2015/16 will be printed and submitted to the MOHLTC based on the above
noted deadlines.
Attachments:
∑ AR 2015/16 Final Draft (Annotated)
158
Together, Making Healthy Change Happen
Annual Report 2015 - 2016
June 2016
159
MANDATE
The Central West Local Health Integration
Network (LHIN) was established under the
Local Health System Integration Act
(LHSIA, 2006) and given authority to plan,
fund, integrate and monitor the local
health care system for the purpose of
improving the health of residents who live
in communities within the LHIN’s
geographic boundaries.
MISSION
To improve access to and the quality of,
health services for residents of the Central
West LHIN, through strengthened
integration and coordination of health care
services.
CONTENTS
3 Message from the Board Chair and CEO
6 Board of Directors
7 Glossary
8 Overview
9 Section 1 | Context
9 1.1 Strategic Directions and Alignment
10 1.2 By the Numbers
15 Section 2 | Healthy Change
2.1 Improve Access to Care
15
18
19
22
VISION
“To create a health care system that helps
people stay healthy, delivers good care
when people need it and will be there for
our children and grandchildren.”
26 2.2.1 Improve linkages with and among primary/family health care
and other providers in the health care system
28 2.2.2 Improve System Navigation Resources
28 2.2.3 Increase system collaboration through use of information
Technologies
2.3 Drive Quality and Value
30 2.3.1 Ensure an overarching LHIN quality framework
31 2.3.2 Optimize use of health care resources to foster better
Value
GUIDING PRINCIPLES
The Central West LHIN has adopted the
following principles to guide its planning
processes:

Equitable access based on
patient/client need

Preservation of patient/client choice

People-centered, community-focused
care that is responsive to local
population needs
Primary Health/Family Health Care
Chronic Disease Prevention and Management Programs
Mental Health and Addictions Services
Community-Based Services for Seniors
2.2 Streamline Transitions and Navigation of the System
VALUES
Person-centred
Transparency
Integrity
Stewardship
2.1.1
2.1.2
2.1.3
2.1.4
2.4 Build Momentum
34
36
36
37
38
2.4.1
2.4.2
2.4.3
2.4.4
2.4.5
Aboriginal Health
Diversity and Health Equity
French Language Services
Palliative and End-of-life Care
Women’s and Children’s Health
39 Section 3 | Central West LHIN Performance
53 Section 4 | Engaging LHIN Communities
57 The Road Ahead... IHSP 2016-19
62 Financial Statements

Measureable, results-driven outcomes
based on strategic policy formulation,
business planning and information
management

Shared accountability among
providers,
government,
community
Central West
LHIN | Annual Report 2015/16
1
and citizens.
160
161
2
TOGETHER,
MAKING HEALTHY
CHANGE HAPPEN
A Message from the Board Chair and CEO
Maria Britto
Board Chair
Scott McLeod
CEO
The Central West Local Health Integration Network (LHIN) is pleased to present Annual
Report 2015-2016 (AR 2015/16),showcasing progress and achievements made during fiscal
year April 1, 2015 through March 31, 2016. This represents the the third and final year of the
LHIN’s current strategic plan, otherwise known as an Integrated Health Service Plan (IHSP),
IHSP 2013-2016.
Together, Making Healthy Change Happen takes its title from a shared sense of responsibility. It
reflects an understanding and acceptance that by working together, as a collaborative team of
health service providers (HSPs), community partners, residents and the LHIN organization, we
can do so much more to bring about “healthy change” across the local health care system.
Accordingly, during 2015/16 and throughout the entire span of IHSP 2013-2016, it was as a team
that the LHIN remained committed to the development of a more accessible and integrated local
health care system, responsive to the needs of residents and patients while delivering better value
for money.
The Central West LHIN was one of the first of Ontario’s 14 LHINs to implement Health Links fully
across its entire geographic area and, a majority of LHIN residents (94%) now report having a
regular family doctor.
The three emergency departments (EDs) located in the Central West LHIN have lower proportions
of low acuity visits compared to the province on the whole, and the lowest rate of ED visits among
the 14 LHINs for minor conditions including conjunctivitis (pink eye), cystitis (bladder infections),
otitis media (earache) and upper respiratory infections (colds). These are conditions that are most
appropriately managed by a family doctor, and the low rates of ED visits associated with them
suggests that Central West LHIN residents have good access to primary care.
Rates of unnecessary ED visits and readmissions to hospital due to complications associated with
diabetes have decreased. The continued success of the LHIN’s Regional Telehomecare Program
is a strong example of how residents are self-managing their chronic conditions, thereby reducing
the number of unnecessary ED visits and hospitalizations.
The Central West LHIN spent 2015/16 continuing its work with community and hospital partners to
establish the right continuum of adult, community-based mental health and addictions services that
are easily accessible by all residents, regardless of where they look for them or who they ask for
help.
3
Central West LHIN | Annual Report 2015/16
162
With a rapidly growing and aging population, the LHIN undertook a comprehensive, long-term
community capacity study of services for seniors, to identify current service gaps and potential
future challenges within in the system.
As an identified best practice in seniors care, funding to assisted living programs was increased
threefold over an eighteen month period, adding 205 assisted living spaces in Shelburne,
Orangeville, Brampton, Etobicoke and Woodbridge.
A LHIN investment of $1.4M continued to help seniors with complex medical conditions, who have
experienced a recent loss of strength or mobility. The LHIN made multi-year Assess and Restore
money available to the Central West Community Care Access Centre’s (CCAC’s) home
independence program, which provides targeted rehabilitation services to frail elderly in their
homes.
At the Peel Manor adult day program, community funding was used to extend the hours of
operation to accommodate additional seniors every day. There are now nine adult day programs in
the Central West LHIN, with a capacity to serve 248 seniors.
In support of enhanced access to physiotherapy services, the Central West LHIN provided the
Central West CCAC with a base funding allocation of $1.3 million to coordinate expanded home
physiotherapy services for 2,036 additional physiotherapy clients, implementing 149 exercise and
falls prevention classes in 36 locations across Central West LHIN.
Continuing to have positive, sustained results for the patient and local health care system, the
LHIN’s regional Telehomecare program enrolled 1,728 patients. The in-Patient admission rate
dropped from 1.92 episodes/patient pre -program enrollment, to 0.46 episodes/patient after
discharge. Average length of stay decreased, on average, by more than a day post discharge, and
the ED visit rate dropped significantly from 3.10 visits/patient pre enrollment to 0.91 visits/patient
post discharge.
Throughout 2015, the Central West Palliative Care Network (CWPCN) applied the provincial
Declaration Document of 2011 to further develop a local palliative care system and, as a founding
partner in the development of a joint palliative and end-of-life care “Pledge”, the Central West LHIN
took a leadership role in continuing to advance the palliative and end-of-life agenda.
The Peel Aboriginal Network (PAN) was recognized as an Indigenous Friendship Centre, and the
LHIN will continue to work closely with the Network moving into the next three years.
2015 also saw the ongoing development of a collaborative care project between Reflet Salvéo and
the Central West LHIN. Known as the Coalition pour les aînés francophones de Peel (CAF), CAF
brings together the collective efforts of le Club du Bel Âge, la Retraite Active et le Cercle des Aînés
Noirs Francophones de l’Ontario to help address both current and future service demands for
seniors from a Francophone perspective.
Following a number of infrastructure announcements in 2013/14 and 2014/15, 2015/16 saw the
advancement and physical development of important projects at several sites, including Etobicoke
General Hospital (EGH), Headwaters Health Care Centre (HHCC), Kipling Acres, Peel Memorial
Centre for Integrated Health and Wellness, Rexdale Community Health Centre and WellFort
Community Health Centre.
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4
Ambitious yet actionable, and flexible in its ability to adapt to the changing needs of the health care
environment, it is rooted in the common vision and priorities of Ontario’s Patients First: Action Plan
for Health Care, and common objectives of Ontario’s 14 LHINs. Focused on quality and outcomes
it is built upon four strategic directions which, together with their respective strategic initiatives and
actions, act as the foundation of a bold but realistic roadmap for the local health care community.
Working together, these directions, initiatives and actions establish a comprehensive, focused and
disciplined approach toward the attainment of desired outcomes, and reaffirm the Central West
LHIN’s commitment to put people and patients at the centre of their local health care system … to
improve their health care outcomes and experiences.
IHSP 2016-2019 provides the Central West LHIN with the foundation necessary to meet new
challenges, and to take a leadership role in the advancement of high-quality, patient-centred health
care across Ontario.
IHSP 2016-19 provides the Central West LHIN with the foundation necessary to meet new
challenges, and to take a leadership role in the advancement of high-quality, patient-centred health
care across Ontario.
Both residents and health care professionals alike place high value on their health care system,
and the need for it to be responsive to local communities. The Central West LHIN thanks the many
HSPs, community partners and local residents who have actively engaged in helping to bring about
healthy change across their local health care system. Their dedication, commitment and
collaborative efforts toward the provision of high-quality, person-centred, local health care is
transforming a bold vision into reality.
Is there still a lot more to accomplish… absolutely! With system building there will always be room
for improvement. Nevertheless, , but the local health care system is further ahead today than when
the Central West LHIN was first established a decade ago.
Is the LHIN up to the challenges that lie ahead… lLet there be no doubt, the LHIN is up to the
challenges answer is a resounding yes! that lie ahead and together, we will make healthy change
happen.
Kindest Regards,
Maria Britto
Board Chair, Central West LHIN
5
Scott McLeod
Chief Executive Officer, Central West LHIN
164
BOARD OF DIRECTORS
Maria Britto *
Chair
June 9/11 – June 8/14
June 9/14 – June 8/17
* Denotes Reappointment
Hon. John McDermid *
Vice Chair
Adrian Bita
Director
Lorraine Gandolfo *
Director
Suzan Hall *
Director
June 9/11 – June 8/14
June 9/14 – June 8/17
May 6/15 – May 5/18
Oct. 27/10 – Oct. 26/13
Oct. 27/13 – Oct. 26/16
May 17/11 – May 16/14
May 17/14 – May 16/17
Gerry Merkley *
Director
Jeff Payne
Director
Ken Topping *
Director
June 17/10 – June 16/13
June 17/13 – June 16/16
Pardeep Singh Nagra *
Director
May 27/15 - May 26/18
June 9/11 – June 8/14
June 9/14 – June 8/17
Oct. 6/10 – Oct. 5/13
Oct. 6/13 – Oct. 5/16
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6
GLOSSARY
ABP
ALC
AR
BCH
BSO
CAF
CCAC
CDPM
CHC(s)
CHF
COPD
CSS(s)
CWPCN
ED(s)
EGH
EMR
FHG(s)
FHO(s)
FHT(s)
FLS
7
Annual Business Plan
Alternate Level of Care
Annual Report
Brampton Civic Hospital
Behavioural Supports Ontario
Coalition pour les aînés francophones de Peel
Community Care Access Centre
Chronic Disease prevention and Management
Community Health Center(s)
Congestive Heart Failure
Chronic Obstructive Pulmonary Disease
Community Support Service(s)
Central West Palliative Care Network
Emergency Department(s)
Etobicoke General Hospital
Electronic Medical Record
Family Health Group(s)
Family Health Organization(s)
Family Health Team(s)
French Language Services
H2H
HHCC
HIP
HRM
HSP(s)
HQO
IAR
IDEAS
IHSP
IM
IT
LHIN(s)
LHSIA
LTC
MOHLTC
OTN
PAN
SAM
InSTED
QBP(s)
Hospital to Home
Headwaters Health Care Centre
Home Independence Program
Hospital Report Manager
Health Service Provider(s)
Health Quality Ontario
Integrated Assessment Record
Improving and Driving Excellence Across Sectors
Integrated Health Service Plan
Information Management
Information Technology
Local Health Integration Network(s)
Local Health System Integration Act
Long-Term Care
Ministry of Health and Long-Term Care
Ontario Telemedicine Network
Provincial Aboriginal Network
System Access Model
Short-Term Emergency Department Diversion
Quality-Based Procedure(s)
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OVERVIEW
An extension of IHSP 2013-2016, Annual Report 2015-2016 showcases the progress and
achievements made for the fiscal year beginning April 1, 2015 and ending March 31, 2016. It
outlines how together, with local health service providers (HSPs) and the broader health
care sector, the Central West LHIN has made notable gains related to the strategic
directions identified in IHSP 2013-2016, and specific actions identified in ABP 2015-2016.
Highlights include...

Section 1 | Context - Overview of the Central West LHIN’s strategic directions; alignment with
the Ministry of Health and Long-Term Care (MOHLTC) and pan-LHIN priorities; and,
population and health profiles of local residents.

Section 2 | Healthy Change - Specific achievements and progress made in support of ABP
2015-16 and IHSP 2013-2016.

Section 3 | Central West LHIN Performance Indicators - Review of 2015/16 system
performance and financial accountabilities established between the MOHLTC and Central
West LHIN.

Section 4 | Engaging Central West LHIN Communities - Summary of communications and
community engagement activities during the 2015/16 fiscal year.

“The Road Ahead” - Looking ahead to IHSP 2016-2019.

Financial Statements - Comprehensive outline of the Central West LHIN’s audited financial
statements including an independent auditor’s report, statements of financial position,
activities, changes in net debt and cash flows.
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CONTEXT
1.1 Strategic Directions and Alignment
Aligned with Ontario’s first Action Plan for Health Care, IHSP 2013-2016 focuses on four strategic
directions and their related initiatives. It outlines the Central West LHIN’s priorities with respect to
placing patients first, building a more accessible and integrated local health care system
responsive to their needs while simultaneously delivering better value for money.
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1.2 By the Numbers
Population Profile
The Central West LHIN has grown substantially over the past decade, from 740,000 residents in
2006 to over 922,000 present day (seven percent of Ontario’s population). With the highest
projected growth rate in the province, over 17,000 new residents each year, the LHIN’s population
is expected to grow to almost 1.1 million by 2025. Not only is the Central West LHIN’s population
growing, it is aging. By 2025, the population of seniors (those aged 65 or more) is expected to
increase by 62%, from 111,000 to 180,000.
One of the most geographically and ethnically diverse LHINs in the province, 86% of LHIN
residents reside in urban areas, 8% in a suburban setting and 7% in rural communities. 47% of
residents are immigrants, seven percent of whom are new to Canada within five years.The LHIN is
also home to over 14,000 Francophone residents and 5,600 residents who self-report as
aboriginal people.
Over the past five years, notable investments have improved access to a variety of health care
programs and services in the Central West LHIN. Regardless of the challenges associated with the
realities of a rapidly growing, ageing, and ethnically diverse population the LHIN,in collaboration
with health service providers (HSPs) and community partners, remains committed to the planning,
development and delivery of innovative and creative health care programs and services that meet
the current and future needs of LHIN communities.
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10
Home to over
920,000 residents,
the Central West
LHIN is a mosaic of
geographic and
cultural diversity
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170
Health Profile and Access to Care
Timely and appropriate access to primary health care are key objectives identified in Ontario’s first
Action Plan for Health Care and IHSP 2013-2016. While almost all ( 94%) of LHIN residents report
having a regular primary care provider, only 53% report the ability to see a primary care provider
on the same or next day when sick. These indicators are particularly important for the Central West
LHIN’s population given the prevalence of certain chronic conditions and premature mortality.
Between 2009 and 2013 the proportion of Central West LHIN residents with at least one chronic
condition decreased, and is significantly lower than the province. Prevalence decreased for every
chronic condition, with the exception of Chronic Obstructive Pulmonary Disease (COPD). The
prevalence rate of COPD doubled in the Central West LHIN, from 2.1% to 5.0%, while Ontario’s
rate remained the same. Meanwhile, given the unique blend of an unprecedented growth in the
seniors population combined with higher proportions of high risk ethnic groups residing within the
Central West LHIN, the prevention and management of diabetes will continue to remain a local
priority.
Many chronic conditions can be prevented or their onset delayed. Smoking, misuse of alcohol,
excess weight, poor diet and physical inactivity are well established modifiable risk factors for many
chronic conditions. The Central West LHIN has the lowest percentage of smokers (12%) and the
second lowest proportion of heavy drinkers (12%) in the province. Conversely, rates for obesity
(56%) and physical inactivity (54%) are higher than provincial values.
In 2015/16, there were 256,437 ED visits to hospitals in the Central West LHIN, an increase of 18%
over 2010/11. With 27% more visits annually than the next busiest site, Brampton Civic Hospital
(BCH) is home to the busiest ED in Canada. Hospitals in the Central West LHIN had the lowest
rate of visits best treated in alternative primary care settings (a 30% reduction since 2010/11),
meaning that the very high number of ED visits are appropriate. ED length of stay for patients
discharged home from EDs in the Central West LHIN consistently meets provincial targets.
However, length of stay for patients requiring admission to an inpatient bed is substantially higher
than target, suggesting a need for continued investment in inpatient capacity.
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Health Care Resources and their Use
Over the past seven years a 21% increase in base funding, totalling $156 million (from $727 million
in 2009/10 to $883 million in 2015/16), has resulted in improved access to a variety of health care
programs and services in the Central West LHIN.
More specifically, through a budget of $883 million provided by the MOHLTC, the Central West
LHIN funds HSPs and community partners in the regions of Brampton, Caledon, Dufferin County,
Malton, north Etobicoke and west Woodbridge.






2 hospital corporations across three sites… attending over 70,000 hospital admissions and
250,000 emergency department visits/year
1 Community Care Access Centre (CCAC)… serving over 32,500 clients/year
23 Long-Term Care (LTC) Homes … providing an estimated 750,000 resident days/year
2 Community Health Centers (CHC) across 5 locations… delivering over 25,000 primary care
visits/year
15 Community Support Service (CSS) agencies… offering services to over 40,000 clients/year
8 mental health and addictions organizations… providing over 20,000 interactions to local
LHIN residents/year.
Service Accountability Agreements
(SAAs)
Funded
HSPs
Base Funding
% of LHIN
Funding
Acute Care Hospitals
2
$533,247,731
60.4%
Community Care Access Centres (CCACs)
1
$115,820,159
13.2%
Community Health Centres (CHCs)
2
$12,182,882
1.5%
Community Support Services (CSS)
15
$22,791,232
2.6%
Long-Term Care (LTC) Homes
23
$158,625,567
17.9%
Mental Health and Addictions Services
Total
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8
$37,883,405
4.4%
52
$883,716,367
100%
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SIGNIFICANT sector investments* over the past seven years to improve
the health and healthy outcomes of Central West LHIN residents. (*Increase from 2009/10 yearend, to 2015/16year-end)
Hospitals
$465,884,631
$533, 247,731
Community Care Access Centres
$77,593,209
$115,820,159
Community Health Centre’s
$6,668,770
$12,182,882
Long-Term Care Homes
$136,059,183
$158,625,567
Mental Health and Addictions
$30,647,492
$37,883,405
$67,363,100 or 14%
$38,226,950 or 49%
$5,514,112 or 83%
$22,566,384 or 17%
$7,235,913 or 24%
Community Support Services (incl. Assisted Living)
$11,523,426
$22,791,232
$727,403,702 (2009/10)
$11,267,806 or 98%
$883,716,367 (2015/16)
$156,312,665 or 21%
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HEALTHY CHANGE
“Healthy Change” reflects upon local initiatives, specific work and accomplishments related
to the four strategic directions identified in IHSP 2013-2016 including Improve Access to
Care, Streamline Transitions and Navigation of the System, Drive Quality and Value, and
Build on the Momentum. These activities outline how, together with health service providers
(HSPs) and community partners, the Central West LHIN has continued to place patients first
throughout 2015/16.
2.1 Improve Access to Care
2.1.1 Improve Access to Primary/Family Health
Care
Throughout 2015/16 the Central West LHIN continued to work with Family Health Teams (FHTs),
Community Health Centres (CHCs), and other primary care practitioners practicing in other models
of organized care, to ensure residents have timely access to multi-disciplinary primary care,
provided in appropriate settings as close to home as possible. Of note, the LHIN is working with
providers to develop systems and processes that will prevent or delay deterioration in the activities
of daily living, whch will reduce avoidable admissions to hospital and applications to Long-Term
Care.
Current Status | Approximately 560 family physicians provide care throughout the Central West
LHIN (*Ontario Physician Health Data Resource Centre, 2013). Residents have access to six
FHTs, two CHCs, 33 Family Health Groups (FHGs), 13 Family Health Organizations (FHOs), and
over 180 individual fee-for-service practitioners. Attachment to a primary care physician is high,
with 94% of residents of the Central West LHIN reporting they had a regular family doctor in 2015
(*Health Care Experience Survey, December 2015). While most residents report having a family
doctor, only 53% of residents reported that they could see their primary care provider on the same
or next day when sick.
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174
Residents do not appear to be turning to local emergency departments (EDs) for conditions that
should be manageable within the community. Despite Brampton Civic Hospital (BCH) having the
busiest ED in both Canada and Ontario (137,818 visits in 2015/16, as compared to 123,132 at
Humber River Regional in Ontario), the three EDs in the Central West LHIN have lower
proportions of low acuity visits compared to the province as a whole (Canadian Triage and Acuity
Scale (CTAS) IV/V: 17% vs. 32%) and the lowest rate of ED visits among the 14 LHINs for
conditions such as conjunctivitis, cystitis, otitis media and upper respiratory infections, that could
be treated in primary care settings (1.1 per 1,000 population aged 1-74 years in 2013/14).
As one of the first of Ontario’s 14 LHINs to implement five Health Links fully across its entire
geographic area (Bolton-Caledon, Bramalea and Area, Brampton and Area, Dufferin Area and
North Etobicoke-Malton-West Woodbridge), the Central West LHIN continued to play a key role in
the collaborative design and implementation of Health Links in 2015/16.
HealthLinks is an innovative approach to care, designed to drive positive outcomes for patients
with complex conditions… patients who typically have multiple diagnoses and complex
medication regimens, and whose circumstances significantly impair their ability to perform one
or more activities in their daily living.
HealthLinks bring together multiple health care providers and their services within a local area
- hospitals, family doctors, Long-Term Care Homes, community partners and other
organizations – so that everyone involved in a patients circle of care, knows and understands
their health goals, shares information, and works collaboratively to place the patients’ needs
first.
When multiple health service provider’s work together as a team, patients receive better, more
coordinated care. HealthLinks places patients at the centre of care, so they can feel supported
and more confident about their health and healthy outcomes.
HealthLinks
Reduce…




the need for emergency department visits and inpatient admissions
avoidable re-admission to hospitals after discharge
time for referral from primary care doctor to specialist appointment
applications to long term care
Improve…



patients’ experience as they navigate in and around the health care system
the patients’ quality of life
access to family care for seniors and patients with complex conditions.
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Within any given year, the number of complex high needs patients in the Central West LHIN is
projected to be approximately 42,000 or five percent of the Central West LHIN’s total population.
Based on a common definition of complex high needs patients, ... those with four or more comorbidities, ... ongoing identification of the Health Links patient population continued throughout
2015/16, with Health Links Care Coordinators continuing to develop tailored, individualized care
plans for each patient.
It is also important to note that throughout 2015/16 the Central West LHIN continued to support the
work of the Central West Primary Care Network. Led by the Primary Care Lead, Dr. Frank Martino,
this collective supports and develops diverse partnerships and strategies to engage local primary
care practitioners, particularly in relation to initiatives such as Health Links.
Thanks to the collaborative work of Health Links, HSPs and community partners, the LHIN has
increased the capacity of primary care providers to care for the needs of the most complex
patients, improving their outcomes through comprehensive individualized care planning among
local partners.
As the LHIN population grows and ages rapidly over the next several years, Health Links will
continue to play an increasingly important role, addressing the capacity of primary care providers to
care seamlessly for complex high needs patients and encouraging greater collaboration among
local providers in order to improve outcomes.
Coordinated Care
Improves Outcomes
“Nasir”, an 82-year-old married man, who speaks no English, frequently visited his nearby
hospital ED to obtain free acetaminophen.
A Care Coordinator and translator, from the local Health Link associated with the Central West
CCAC, discovered that Nasir had been visiting the ED to relieve pain from an untreated hernia.
He did not know to arrange for surgery through the specialist he had been referred to. Through
the Health Link, the patient’s primary care provider and CCAC Care Coordinator developed a
tailored coordinated care plan to meet Nasir’s pre and post-operative needs.
Following surgery and post-discharge, the care coordinator continued to work closely with Nasir
and his family doctor to ensure receipt of appropriate care in line with the care plan and Nasir’s
changing needs.
Submitted by the Central West CCAC
*Names have been amended to ensure privacy
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2.1.2 Improve Access to Chronic Disease
Prevention and Management Programs
Throughout 2015/16, the Central West LHIN worked with community partners to continue to
improve the treatment and management of chronic diseases in the community, increasing capacity
for the self-management of chronic conditions. This included efforts made to improve the
coordination of regional diabetes services, and the ongoing expansion of education and selfmanagement programs for chronic conditions including Congestive Heart Failure (CHF) and
Chronic Obstructive Pulmonary Disease (COPD).
Current Status | The active client caseload for Central West LHIN residents attending local
diabetes education programs continued to increase. Despite the LHIN having the third highest
prevalence rate of diabetes in Ontario, ryRates of unnecessary ED visits and readmissions to
hospital due to complications associated with diabetes... hyper and hypoglycemia... have
decreased to below the established target rate of ≤198 per 100,000 populations. Meanwhile, the
number of readmissions to hospital within 30 days of discharge, for conditions related to diabetes,
was at or below the evidence-based expected rate in all four quarters. These indicators reflect the
collective success of the Central West LHIN’s diabetes education and self-management programs.
The ongoing success of the LHIN’s regional Telehomecare program is another strong example of
how residents are using improvements in technology to self-manage care from the comfort of their
own homes, while helping to enable better value through the reduction of unnecessary ED visits
and hospitalizations.
Commented [A1]: This call out has now been populated with
updated content.
The Central West Regional Telehomecare Program makes it possible for residents with
diabetes, CHF and COPD to self-manage their care from the comfort of home.
Patients are referred to the program from a number of regional partners and, through the
assistance of technology, are monitored by Telehomecare nurses working from the host
organization William Osler Health System (Osler).
Evaluations of the first Telehomecare patients revealed a 40% reduction in ED visits and
49% reduction in hospitalizations. These results demonstrate the ability of patients to better
self-manage their conditions within their communities, avoiding and preventing unnecessary
use of acute/ambulatory services.
At the end of 2015/16, theTelehomecare program had enrolled 1,728 clients and continues
to have positive sustained results for patients and the healthcare system.
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In collaboration with William Osler Health System (Osler) and the Wise Elephant Family Health
Team, the Central West LHIN was pleased to present the 5th Annual Chronic Disease Prevention
and Management Conference.
With development of IHSP 2016-2019 taking place throughout most of 2015/16, over 170
participants were challenged to use the conference as an opportunity to "start thinking about
tomorrow... today," using the event as as a forum for information gathering and knowledge
exchange to inform the IHSP planning process, and plan for the future of the local health care
system.
The conference also reaffirmed the LHIN’s continued work with community partners to increase
capacity for the self-management of chronic conditions in order to improve the treatment and
management of chronic diseases in the community. Efforts made to improve the coordination of
regional diabetes services will continue, and the expansion of education and self-management
programs, including Telehomecare, for chronic diseases including CHF and COPD will move
forward.
2.1.3 Improve Access to Mental Health &
Addictions Services
In 2011, the Ontario government released Open Minds, Healthy Minds: Ontario’s Comprehensive
Mental Health and Addictions Strategy, a long-term comprehensive approach to transforming the
mental health system. The first three years of this strategy focused on children and youth. In
2015/16, Building on years one through three, which focused on children and youth, the Central
West LHIN spent 2015/16 focused on aligning with years four through ten of Open Minds, Healthy
Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy. The LHIN expanded
beyond the scope of chirdren and youth to More specifically, the LHIN continued its work with
community and hospital partners in establishing the right continuum of adult, community-based
services, easily accessible for all residents regardless of where they look or whom they ask for
help.
Current Status | The Central West LHIN funds eight HSPs which collectively delivered over
20,000 mental health and addictions interactions to local LHIN residents in 2015/16. Services
range in function, intensity and duration, and include case management, crisis response,
counselling and treatment, early intervention, support within housing, residential withdrawal
management, diversion and court support, social rehabilitation, recreation, health promotion and
employment support.
Providers are being guided by a vision for Mental Health and Addictions services that Emerged
from a series of discussions among HSPs and the LHIN two years ago - “high quality and
seamless services that are easily accessed, efficient, available in a timely way, and meet the
changing needs of people over their lifetime”. The LHIN and HSPs discussed existing service
capacity, strengths and challenges within the system, and determined priorities for program
investments in both 2014/15 and 2015/16.
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178
An investment of $3.9 million over the past two years has led to a number of notable gains within
the Mental Health and Addictions sector.
$3.9 MILLION
Improved access to
Mental Health & Addictions Services
 Reduced existing combined wait list for long-term case
management and early intervention
 Integration of addiction consultation services for residents
working with Health Links to develop a single, coordinated
care plan.
 Enhancement of crisis services whereby clients and their
families engage more meaningfully with crisis workers, and
involvement of specially trained police officers who, teamed
with a regulated health professional, intervene more
appropriately.
 Adoption of person-centered and family-involved crisis
planning approach consistent with local child and youth
services’ practice that defers to clients to decide more
practical strategies for self-managing a crisis, increasing the
likelihood that the crisis plan will be followed. Planned
implementation is underway.
 Enhancement of family support and expansion of social
rehabilitation/recreation, as a systemic way to support client
access to and movement between services with varying
levels of intensity as needed.
 Augmentation of front-line practitioners for short-term case
management and brief therapy to respond more immediately
to the presenting issue and to more readily assess need for
longer term support.
 Efficient use of known housing stock to provide support
within housing to 16 additional individuals and a planned
approach for another 84 people, reducing the wait list by
25%.
 Capability for mental health and addictions staff to provide
coordinated care in the ED, enabled through access to
relevant, electronic clinical records (with client consent) at
Osler and the Central West CCAC.
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20
Improving the quality and use of crisis services provides residents with an alternative to repeated
use of the ED. It also enables first responders to better identify when it is necessary for residents to
visit the ED. Accordingly, the LHIN’s Short-Term Emergency Department Diversion (InSTED)
matured throughout 2015/16, and is successfully providing clients with immediate short-term case
management, often while they are still in the ED.
Data shows that the rate of repeat ED visits within 30 days for mental health has improved over the
last year. The visit rate for Q4 14/15 through Q3 15/16 (the accountability period for FY 2015/16) is
15.6% better than both the provincial target of 16.3% and provincial performance of 19.2%.
Through reporting from Crisis Services and InSTED programs, there appears to be a correlation
between these targeted community-based investments and the improvement in mental health
repeat visits. For instance, Crisis Services are better identifying the need for a hospital visit through
more comprehensive assessments. More of the clients recommended by Crisis Services for an ED
visit are triaged as requiring acute care and are admitted, showing that the need for an ED visit
was appropriately assessed and the visit was necessary. Clients have also self-reported a 60%
reduction in repeat visits for mental health following engagement.
Meanwhile, in February 2016, the Canadian Mental Health Association Peel Branch (CMHA Peel)
and the Caledon Detachment of the Ontario Provincial Police (OPP) announced expansion of 24.7
Crisis Support Peel into Caledon. The launch of this program with Caledon OPP builds on the
success that 24.7 Crisis Support Peel has experienced over the last year in partnership with Peel
Regional Police. Since program redesign and enhancement last March, 24.7 Crisis Support Peel
has exceeded all expectations with almost 20,000 interactions (calls, visits, follow-ups) with
individuals in mental health or addictions crisis. Despite this, the apprehension rate for the program
is only 9% (under Section 17 of the Mental Health Act, police have authority to apprehend and take
someone to hospital). Almost 100% of those clients have been admitted to hospital, reducing
unnecessary ED visits.
Over the last three years, attention was focused on development of a System Access Model (SAM)
for Mental Health and Addictions services, ensuring alignment to similar initiatives taking place in
surrounding LHINs. There is full support to establish coordinated access that provides
comprehensive information about support and treatment options based on the level of need, and
that facilitates service transitions or interim support while waiting. The SAM was endorsed through
consultations with persons with lived experience (consumers), children’s mental health,
development services, social services, family services, as well as within mental health and
addictions sectors.
Scaled, phased implementation is planned for 2016, with one-time investments having helped to
build the foundational operating aspects of the model i.e., business processes, clinical screening
and assessment tools, service inventory, and pathways. With concurrent evolution of Health Links
and coordinated care planning, and advent of the discussion paper Patients First: A Proposal to
Strengthen Patient-Centred Health Care in Ontario, discussions have ensued regarding expanding
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access to care to a more integrated, holistic model across a broader array of services through use
of information technologies.
Improving mental health services throughout the lifespan is one step toward ensuring the needs of
Central West LHIN residents are placed first; that they remain at the centre of care, receiving better
access, better quality and better value from their local healthcare system. Through early
identification and intervention and enhanced community-based services, the LHIN is working to
ensure that residents with mental health and addictions receive timely access to the most
appropriate services as close to home as possible.
2.1.4 Improve Access to Community-Based
Services for Seniors
In 2015/16 the Central West LHIN continued to work with funded community service providers to
develop strategies that support seniors in the community, increasing their quality of life. This work
is aligned with the province’s Seniors Care Strategy and aims to reduce avoidable ED visits,
hospital admissions and Alternative Level of Care (ALC) designations.
Current Status | The Central West LHIN funds community-based agencies that deliver services to
support the independent living of seniors within the community. Services include social/safety
visiting, congregate dining, adult day programs, transportation, exercise/falls prevention, chronic
disease management, caregiver support, independence training, psychogeriatrics, assisted living,
respite and palliative care. The LHIN also provides funding to the Central West CCAC to deliver
nursing care, rehabilitation and personal support services, rapid response nursing, palliative care,
community clinics and supportive living. The Central West CCAC also coordinates admission to 23
LTC homes across the LHIN.
24.7 Crisis Support Peel
Expanded into Caledon
24.7 Crisis Support Peel is a community crisis
service comprised of specially trained
plainclothes police officers and mental health
professionals. They provide timely response
to adults (16 years and over) experiencing a mental health or addictions crisis; individuals having
difficulties coping; and family, caregivers and friends needing support. The expansion of this
mental health and addictions crisis service builds on the success of 24.7 Crisis Support Peel
already in place in Brampton and Mississauga in partnership with Peel Regional Police.
24.7 Crisis Support Peel features an integrated team for maximum flexibility and
responsiveness, comprised of mental health professionals and specially trained police officers.
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In keeping with other crisis models, officers are in plain clothes and drive unmarked vehicles,
which can help to reduce the stigma surrounding mental illness and also helps to protect the
privacy of the clients. This anonymity also allows clients to feel more at ease with officers,
promoting a more open and trusting relationship and allowing the team to conduct a thorough
and accurate mental health assessment.
 Capacity Planning
Over the next several years, the Central West LHIN is expected to experience unprecedented
growth, higher than that of the province. By 2025, the total LHIN population is expected to surpass
1,099,000, of which nearly 180,000 are expected to be 65 years of age and older. With this rapidly
growing and aging population, the LHIN continues to focus on those who are most in need of
health care services, and has steadily prepared for this extraordinary growth and increased
demand through innovative thinking and current and future planning.
Guided by recommendations in Dr. Samir Sinha’s “Living Longer, Living Well” report, the Central
West LHIN undertook a comprehensive, long term community capacity study of services for
seniors, to identify current service gaps and potential future challenges within in the system.
This work contributed to the development of IHSP 2016-19, it represents a truly collaborative effort
about a topic of mutual interest among the Central West and Mississauga-Halton LHINs, multiple
HSPs, and community partners. The study places patients first by seeking to develop a community
health services plan that meets the needs of a growing and aging population in both LHINs… a
plan that helps people to stay healthy; delivers high-quality, patient-centred care, where and when
needed; and that will be there for their children and grandchildren. .
 Home and Community Care
The Central West LHIN funds 15 Community Support Service (CSS) agencies who collectively
serve over 40,000 clients per year. The Central West CCAC serves over 32,500 clients per year.
Over the past three years, use of home care services has significantly increased. The number of
home care clients in Central West LHIN has increased by 15%, and home care hours have
increased by 51%, indicating an increase both in the number and the acuity of home care clients.
As the LHIN’s population continues to grow and age, the local health care system is shifting from
acute or hospital-based care, to community-based services. As the demand and need for these
services continues to grow, the LHIN must consider the capacity of home care services that will be
required to meet future demand. Throughout 2015/16, home and community care renewal aimed to
keep seniors, particularly the medically complex and frail, safe, healthy and in their homes longer
by having physicians, other health care providers and patients work together to ensuringe
appropriate access to care in the home and communitysector.
As an identified best practice in seniors care, the Central West LHIN increased funding to assisted
living programs, adding 205 assisted living spaces in Shelburne, Orangeville, Brampton, Etobicoke
and Woodbridge, and bringing the total number of funded places to 629.
The Alzheimer Society of Dufferin County and Alzheimer Society of Peel received funds to expand
joint “First Link” programs which support individuals living with dementia and their families.
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A LHIN investment of $1.4M continued to help seniors with complex medical conditions who have
experienced a recent loss of strength or mobility, making multi-year Assess and Restore funding
available to the Central West CCAC’s home independence program (HIP), which provides targeted
rehabilitation services to frail elderly in their homes.
At the Peel Manor Adult Day Program, community funding was used to extend the hours of
operation to accommodate additional seniors every day. There are now nine adult day programs in
the Central West LHIN, with a capacity to serve 248 seniors.
New base funding was designated to expand adult day service hours, home care, respite
programs, caregiver support programs, and Tele-Check programs.
And, the LHIN has continued to invest in the Behavioural Supports Ontario (BSO) program,
building on successes noted in In 2015/16 the LHIN continued to invest in the highly successful
Behavioural Supports Ontario (BSO) propgram . Aa 2014 evaluation of the program indicated that
behavioural support champions and psychogeriatric resource consultants embedded in Central
West LHIN Long-Term Care Homes, were able to reduce responsive behaviours in identified
residents by 47%. Addtionally, results showed a significant decline in the uese of physical
restraints and, i in-home assessments that trigger worsening behavioural symptoms. The LHIN
continued to build on these success by supporting the Buidling on this success,which showed that
23 behavioural support champions embedded in each of the LTC homes, along with the 7
psychogeriatric resource consultants, were able to reduce the number of responsive behaviours of
identified clients by 47%. In addition, the rates of LTC Home assessments that trigger worsening
behavioural symptoms have declined, with a noted substantial decline in the reported use of
physical restraints. Highly successful, Oover 200 unique BSO program referrals were received in
each of the first three quarters of 2015/16, while . while over 4,050 active patients and their
caregivers have been supported during that same time period.
The Central West CCAC, Headwaters Health Care Centre (HHCC) and Osler, as well as the
Ontario Telemedicine Network (OTN) and the Central West LHIN, completed development of the
Hospital to Home (H2H) program. An innovative new model of care, H2H helps to improve clinical
handoffs and information-sharing when patients leave hospital. This means that patients receive
short-term nursing from the same care team after they return home. Right now, H2H is primarily
supporting patients with urinary tract infections and cellulitis but will later expand to help those with
more complex needs.
$1.3M Investment in Exercise
and Falls Prevention
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Throughout 2015/16, the Central West CCAC
successfully implemented 149 Exercise and
Falls Prevention classes across the Central
West LHIN.
The class structure varies based on the frailty of
seniors, with some classes focusing on patients with COPD, and some on stroke patients.
The Central West LHIN continues to work with the Central West CCAC and system partners (i.e.
City of Brampton) and HSPs to increase referrals and engage seniors. Moving forward, the LHIN
will continue to explore innovative ways to increase accessibility and attendance via
telemedicine. In addition, a social determinants of health lens will be integrated to maximize
seniors’ social engagement and education through cross sector partnerships and collaborations.
Magic Abounds when
Daycare and Seniors Home
Share Same Roof (With thanks to the
Toronto Star)
In the second-floor lounge at Toronto’s
Kipling Acres Long-Term Care home, about
15 seniors in wheelchairs and walkers
gather to the throbbing techno beat of
“Gangnam Style” by Korean pop rapper
PSY. Mary Offen, 82, lights up as the children arrive. Her wheelchair rocks while both feet tap
to the music. “I love to dance and I love them,” she says, grabbing the outstretched hands of 3year-old Heaven Tulloch-Rankine. The children from the daycare centre downstairs revel in the
adoration and, while some of them are timid at first, they are soon waving colourful pom-poms,
shaking tambourines and cuddling up to the seniors.
Since the redevelopment of Kipling Acres, and with increased awareness of the benefits of
intergenerational connections, daycare has played a larger role in the home.
The centre’s playground opens onto a courtyard that serves residents, an adult day program,
and a new seniors’ community centre. Lounges with large windows on every floor of the 192bed home also overlook the courtyard so seniors can watch the children play. The “move and
groove” sessions along with bimonthly cooking, crafts, bingo and other activities are part of the
home’s regular programming to help build connections between the children and the seniors.
This is in addition to Halloween costume parades, visits from Santa at Christmas and
celebrations for other special days. Opportunities for spontaneous interaction are also
encouraged.
25
Children learn through experience and at Kipling Acres, they get to experience another
generation they might not see at home. “It was a nice surprise when I saw this,” says Andres
Quiroga whose daughter Yolanda, 3, and 20-month-old son, Isaac, attend the centre. “It’s nice
for my children to see someone like their grandfather,” says Quiroga. His 75-year-old father lives
CentralinWest
LHIN | Annual
2015/16
Colombia
and theReport
children
haven’t yet met him. “Yolanda is more kind to older people since
coming here,” he says. “She is more interested.”
Linda Koslowski, whose 82-year-old mother Stella has Alzheimer’s and has been a resident at
Kipling Acres for just over a year, says having a child-care centre in the home has been a
wonderful bonus. “My mother loves kids. When I take her out to the mall, we have to stop at
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2.2 Streamline Transitions and
Navigation of the System
2.2.1 Improve Linkages With and Among Primary
Health/Family Health Care and other Providers in
the Health Care System
Through Health Links, the Central West LHIN is commited to supporting increased coordination in
primary care settings, ensuring the provision of collaborative community-based care. Health Links
is designed to drive positive outcomes for patients with complex conditions… patients who typically
have multiple diagnoses and complex medication regimens, and whose circumstances significantly
impair their ability to perform one or more activities in their daily living.
Current Status | As one of the first of Ontario’s 14 LHINs to fully implement five Health Links
across its entire geographic area (Bolton-Caledon, Bramalea and Area, Brampton and Area,
Dufferin Area and North Etobicoke-Malton-West Woodbridge), the Central West LHIN continued to
play a key role in the collaborative design and implementation of Health Links in 2015/16.
Based on a common definition of complex high needs patients, those with four or more comorbidities, ongoing identification of the Health Links patient population continued throughout
2015/16, with Health Links Care Coordinators continuing to develop tailored, individualized care
plans for each.
Continuing to have positive, sustained results for the patient and local health care system, the
LHIN’s Regional Telehomecare Program enrolled 1,728 patients. The inpatient visit rate dropped
from 1.92 episodes/patient pre-program enrollment, to 0.46 episodes/patient after discharge.
Average length of stay decreased, on average, by more than a day post discharge, and the ED
visit rate dropped significantly from 3.10 visits/patient pre enrollment to 0.91 visits/patient post
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discharge. The Central West LHIN is currently working with OTN to integrate a health equity lens
to the program to improve access to vulnerable and marginalized populations in the LHIN.
Notably, over the past year, eligible residents with CHF and COPD were better able to self-manage
their care with the support of technology placed in their home through the regional Telehomecare
program. Patients are referred to the program from a number of regional partners and, through the
assistance of technology, are monitored by Telehomecare Nurses working from the host
organization William Osler Health System.
Two goals of Ontario’s Patients First: Action Plan for Health Care are... “to have a family health
care provider for every Ontarian who wants one”, and “to provide more patients with faster, more
convenient access to care.” Building upon work accomplished in 2015, Health Links will continue to
encourage greater collaboration among existing local health care professionals. It follows that with
improved coordination and information sharing, identified residents will receive faster care, spend
less time waiting for services, and be supported by a team of health care providers at all levels of
the health care system.
Commented [A2]: This section call out has now been populated
with current information.
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Sustained Indications for
Health Links
Health Links are teams of local health providers who offer patients with complex conditions
better coordinated care through the development of care plans that meet the specific needs of
the patient to improve transitions among health care providers.
The following graph represents inpatient and ED utilization across Central West LHIN Health
Links between the period April 1 2015 and September 30, 2015. 606 unique patients with
individualized, coordinated care plans are represented.
decreased by
31% and ED visits decreased by 29% after care plans were initiated.
A “before and after” analysis indicates that total inpatient episodes
Commented [A3]: This section call out has now been populated
with current information.
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Telehomecare in the Central West LHIN
The Telehomecare program enables patients with chronic heart failure (CHF) and/or chronic
obstructive pulmonary disease (COPD), who have visited the hospital multiple times, to selfmanage their chronic conditions from the comfort of their own homes or local communities.
Ontario’s Telehomecare program has demonstrated consistent outcomes with greater than 50%
reductions in hospital ED and IP visits for over 9,000 patients.
Through 2015/16 the Central West LHIN Telehomecare program received 3,363 referrals, 1,728
clients were enrolled, and 1,467clients had been discharged. The above graph shows a notable
decrease in both inpatient episodes and emergency department visits during and after
implementation of Telehomecare.
post-discharge ED visit rate dropped by
discharge inpatient admissions rate by 75%.
In 2015/16, the
71% and post-
2.2.2 Improve System Navigation Resources
Throughout 2015/16 the Central West LHIN continued to work with HSPs and community partners
to understand and address barriers to system access, developing integrated care pathways and
care plans to help understand where and when to access needed health care after discharge from
hospital. In so doing, the LHIN sought to partner with community and government agencies to
strengthen system navigation and support the establishment and use of services, such as Health
Links and Telehomecare.
Current Status | Although Llength of stay has decreased and stabalized for for those patients
discharged from the ED to home. have decreased and stabilized, ongoing innovation and
commitment from all systems partners is required to maintain the positive gains made, while
support further improvement. At the same time,Meanwhile, reducing wait times for patients
admitted to an inpatient bed remains remains a challenge. there have been increasing difficulties
in reducing wait times for patients admitted to an inpatient bed. It follows that there has been a
need to direct attention on inpatients, throughput and inpatient admission avoidance through
continued focus direct attention on the a system-level view of to patient flow, both within the
hospital and at the points of transition between health service providers. Since its inception in
2013, the work of the Central West LHIN Patient Flow Core Action Group has been focused on
formulating recommendationsdeveloping and implementing strategies that support thisapproach.
to address these issues.
In 2015/16, the Central West LHIN remained committed to ensuring residents received improved
access to care in the most appropriate settings. LHIN priorities are reflected across a number of
priority areas including the Central West CCAC’s expanded role of waitlist management, ongoing
support for Home First, development of the Hospital 2 Home program, improving the quality and
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use of crisis services, further implementation of information technologies such as Telehomecare
and Telemedicine, and the ongoing implementation of Health Links.
2.2.3 Increase System Collaboration through the
use of Information Technologies
Information technology (IT) and information management (IM) are enablers for patient
empowerment, and secure patient information exchange between providers. They reduce
duplication and frustrationby eliminating the need for patients to repeat the same information on
multiple occasions to different health care professionals. And, they support patients, their
caregivers and health care professionals to share information, coordinating services quickly and
efficiently between transitions in care.
Current Status | In 2015/16, the Central West LHIN continued to make significant strides in
planning and implementing enabling technology solutions. All hospitals in the LHIN are now live
using Hospital Report Manager (HRM). HRM electronically delivers medical record reports (e.g.
discharge summaries) and transcribed diagnostic imaging reports from hospitals, directly into the
patients’ charts in the Primary Care Physicians’Electronic Medical Record (EMR) system.
Brampton Civic Hospital (BCH), Etobicoke General Hospital (EGH) and HHCC are continuing to
expand electronic access of their hospital reports to primary care physicians and specialists
through the use of the HRM product.
The Central West LHIN continues to have the highest EMR adoption rate in the province for
primary care physicians at 87% (vs. 77%), and specialists at 62% (vs. 30%), enabling the greater
sharing of consistent electronic information among HSPs.
The Integrated Assessment Record (IAR) allows client assessments to move with the client
between HSPs, enabling participating HSPs to upload and view case histories from consenting
clients. HSPs are better able to effectively plan, coordinate and deliver care. The tool also
streamlines patient information so there is less duplication and faster access to services. Use of
the IAR by HSPs in the Central West LHIN is stable at 63%. Providers include the Central West
CCAC, 11 Community Support Service Providers, 7 Mental Health Service Providers and 23 LongTerm Care Homes.
Throughout 2015/16 the Connecting GTA (cGTA) project continued to work with HSPs to provide a
single point of access to patient health information. Osler is live feeding data to the cGTA data
repository, and viewing patient information from 11 early adopter hospitals and six CCACs located
in the GTA. HHCC, along with 10 additional Central West LHIN HSPs, is included in the cGTA
expansion phase, expected to go live in the 2016/17 fiscal year. Represented are HSPs from the
Primary Care, LTC Home, Mental Health and Addictions, and Community Support Services (CSS)
sectors.
In 2015, to better understand IM/IT in the community sector, a survey was issued to Community
Sector HSPs across the Central, Central East, Central West and Mississauga Halton LHINs. The
survey collected a broad range of data that has been populated into a database tool for analysis.
The collated and cleansed data has been assessed and identification of a set of IM/IT opportunities
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that can be specifically targeted to home and community care HSPs have been identified.
Implementation of identified opportunities are currently being assessed for future implementation.
The need for central intake processes and a referral management solution to support the intake
processes, has been identified by multiple providers for multiple patient care pathways across the
Central West LHIN. Work will continue in 2016/17 to identify and define patient care pathways that
would benefit from a central intake model and support the implementation of a single referral
management solution. Examples of care pathways include Health Link referrals, Mental Health and
Additions referrals, Diabetes referrals, and Primary Care to Specialist referrals.
The Ontario Lab Information System (OLIS) has collected more than 85% of the provinces lab test
results through connections with hospitals, community labs and public health labs. HHCC and
Osler continue to populate OLIS with test results from their labs. Approximately 430 clinicians in
the Central West LHIN can now view OLIS data for their patients through their EMR systems.
2.3 Drive Quality and Value
2.3.1 Ensure an Overarching LHIN Quality
Framework
In 2015/16, the Central West LHIN remained hard at work supporting initiatives that improve quality
and increase capacity for improvement. The LHIN incorporated patient/client experience into
quality indicators, and developed a collaborative and integrated approach with HSPs to support the
further development of quality improvement plans and undertake accreditation processes.
Current Status | The Central West LHIN is committed to the implementation of a local quality
framework and agenda that places patients first, enhancing their experience with the local health
care system while enabling improved outcomes.
All funded HSPs in the LHIN have signed Service Accountability Agreements (SAAs) that detail
specific performance expectations to be achieved over the term of the agreements. In all of the
accountability agreements it holds with HSPs, the Central West LHIN has incorporated a
requirement for them to be accredited by March 31, 2017. Progress against this requirement is on
track.
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Meanwhile, in accordance with legislation, the LHIN has aslo required HSPs to submit Quality
Improvement Plans (QIPs), which outline an organizations quality improvement goals for the
following year.The Excellent Care for All Act 2010 requires all public hospitals, inter-disciplinary
primary health care organizations, CCACs and Long-Term Care homes to develop and submit an
annual Quality Improvement Plan (QIP). Beyond legislative requirments, to support system
alignment and identify priorities for local quality improvement initiatives, the LHIN has additionally
required that quality plans be completed by community support service agencies.
Next steps will involve collaboration with local HSPs to identify opportunities to align quality
strategies and support for system level quality improvement aims – Improve System Navigation,
Improve Access to Mental Health and Addictions Services, and Improve System Navigation
- established by the LHIN in 2014/15. With implementation of a new three-year health system plan
expected in 2016/17, the LHIN will determine the need to revisit, confirm existing, and/or establish
additional quality improvement aims that reflect priories identified in IHSP 2016-2019.
The Central West LHIN Board of Directors maintained a focus on good governance in 2015/16. A
highlight among health care professionals across the LHIN are the LHIN-hosted Governance and
Leadership Forums. With 2015/16 representing a year of transition, the ability to engage with and
harness the thoughts of over 180 health care professionals at one time, proved invaluable to the
planning processes related to IHSP 2016-2019 and the MOHLTC discussion paper Patients First:
A Proposal to Strengthen Patient-Centred Care in Ontario.
2.3.2 Optimize Use of Health Care Resources to
Foster Better Value
Hospitals beds are a valuable and often scarce resource. When people are unnecessarily admitted
to hospital or are designated Alternative Level of Care (ALC) Alternate Level of Care (ALC) refers
to those patients who continue to occupy hospital beds after they have completed a course of
treatment for which they were admitted and no longer require the care associated with those beds.
they are, by definition, not receiving the right care in the right place. Alternate Level of Care (ALC)
refers to those patients who continue to occupy hospital beds after they have completed a course
of treatment for which they were
admitted and no longer require the care associated with those beds. For a variety of reasons,
these patients experience barriers to discharge from hospital. , place at the right time., hindering
access to those who need them most. Inaccessible resources drive up wait times across the entire
health care system. , which is why i
In 2015/16, the Central West LHIN worked to improve access to acute care capacity. . Specifically,
the LHIN sought to provide more appropriate care to all residents by supporting expanded
community-based services and by seeking improvements in admission, bed use, and discharge
processes. Additionally, the LHIN continued to implement Health System Funding Reform (HSFR)
initiatives that support best practice, cost-effective treatment and care.
Current Status | In 2015/16 the Central West LHIN hads the highest proportion of high-acuity ED
visits in the province. . In 2014/15,More specifically, when compared to the province (68%), 81%
vs. 68% of all ED visits were triaged as high-acuity. The result… 13% of all ED visits and 16% of
high-acuity ED visits resulted in an inpatient admission. The LHIN met provincial ED wait time
targets for patients discharged to the community from the ED, discharging 93% of low-acuity
patients within four hours, and 93% of high-acuity patients within eight hours of presenting in the
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ED. These improvements are largely attributable to the Pay for Results program, now in its ninth
year, which targets patience experience in the ED.
The number of patients processed through the system without being designated as ALC continued
to increase, and the number of patients being discharged with an ALC designation declined.Central
West LHIN ALC designations (1,479) and discharges (1,508) declined in 2015/16. In the Central
West LHIN 1,479 patients were designated ALC, while 1,508 ALC-designated patients were
discharged. A total of 20,065 ALC days were accumulated in 2014/15. Although the Central West
LHIN maintains one of the lowest rates of inpatient capacity lost to ALC, work continues toward
reducing ALC designations.
In 2013/14, funding for selected surgeries and diagnostic wait times shifted to a new Quality-Based
Procedures (QBP) model in which HSPs are expected to deliver these procedures within funded
amounts while maintaining or improving wait times. Since QBP implementation, the LHIN has
experienced improvement in wait times for diagnostic imaging. Notably in 2015/16, 72% of patients
received computerized tomography (CT) within the provincial access target of 28 days.
Governance and Leadership
Forums... Together, Making Healthy
Change Happen
With respect to magnetic resonance imaging (MRI), the Central West LHIN has moved from rates
below 20% in 2010/11, to performance above 71% in 2015/16. In 2015/16 more than 89% of
cancer surgeries and over 87% of cataract surgeries were consistently performed within provincial
access targets.
Opportunities for improvement remain. Wait times for hip and knee replacement continue to grow
and the number of residents receiving these surgeries within the provincial access target continues
to decline. The LHIN has worked with its hospitals to improve performance, but the overwhelming
demand for these procedures continues to outstrip the supply.
 Health System Funding Reform
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The Central West LHIN and many local HSPs now operate in a patient-based funding environment
known as Health System Funding Reform (HSFR). HSFR is a new way of funding hospitals and
community providers based on the burden of illness and care needs in the community, where
patients actually go for care, the quality of providers’ care, and the efficiency of that care. It
represents a more fair means ofconsistent approach to funding health care across the province
that also incents the best possible care in the most efficient way possible – in other words, to drive
quality and value. Throughout 2015/16 and moving forward, the Central West LHIN intends to
further support the provincial HSFR strategy, and work to better align funding to need and
evidence-based practice.
Throughout 2015/16, the Central West LHIN continued to advance the provincial HSFR strategy
through active participation in the pan-LHIN HSFR Advisory Committee, and the MOHLTC’s
renewed HSFR governance structure and implementation of annual HSFR initiatives with local
HSPs. The Central West LHIN continued to identify and monitor the health service needs of the
local community, and work towards the goal of putting patient’s needs first while aligning funding
and delivery of high quality care in an affordable and sustainable manner.
HSPs in the Central West LHIN actively supported HSFR quality improvement and change
management strategies by participating in three cohorts of the provincial Improving and Driving
Excellence across Sectors (IDEAS) program, and continued to collaborate on implementation of
Quality- Based Procedures (QBPs). To date HSP leadership have established a number of QBP
implementation teams that have or are currently implementing strategies for alignment with best
practice and health outcomes. Planning is underway to work more closely with Health Quality
Ontario (HQO) that will further align QBP and quality goals locally.
In September 2015, the MOHLTC announced six innovative projects focused on the patient
experience that would test innovative integrated approaches of service delivery and new integrated
funding models intended to improve the delivery of quality, evidenced-based care to patients.
Hospital to Home (H2H): The Central West Integrated Care Model was one of these selected
projectsselected as a 3-year proof of concept project. . H2H is a model of care that will better
enable seamless patient transitions from the hospital to the community. It is a joint initiative of the
Central West CCAC, HHCC and William Osler Health System (Osler), working in partnership with
OTN.
In Q3 2015/16, H2H began to enroll patients from Osler’s Etobicoke General Hospital (EGH) site,
with implementation at HHCC and Osler’s Brampton Civic Hospital (BCH) site in Q4. In its first
year, H2H will support patients diagnosed with cellulitis and/or urinary tract infections requiring
short-term nursing interventions. In years two and three, the model will be expanded to more
complex care using both nursing and interdisciplinary models, including palliative care, stroke,
chronic diseases, and appropriate post-surgical procedures., and redefine the interactions and
experiences of these patients with the health care system. At the writing fo this report, 282
patients had been enrolled in the H2H model of care, and a total of 1,857 nursing visits had been
conducted by the end of the fiscal year. Early data suggests that this intervention is having positive
impacts on ED visits, hospital admissions, average hospital Length-of-Stay (LOS), average
community LOS, as well as the average number of nursing visits in the community, when
compared to the pre-intervention period. The H2H model supports a strategic shift to more
community-focused, scheduled care, supporting people to receive care in their homes or in the
community, helping prevent unnecessary emergency department visits and hospital admissions,
shortening the acute length of stay for admitted patients, providing greater continuity of care and
enhancing the patient experience.
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Central West LHIN investment strategies are informed through assessment of local health needs
2.4 Build on the Momentum
Throughout 2015/16 the Central West LHIN devoted time, attention and resources to long-standing
initiatives that are aligned with provincial directions and priorities.
2.4.1 Aboriginal Health
The Central West LHIN has continued to actively engage local Aboriginal communities, with the
aim of better understanding local health and service delivery issues from wellness to mental health,
chronic disease management, and palliative care perspectives. The Central West LHIN is
committed to building capacity within the health system to ensure Aboriginal communities receive
culturally competent care; care that recognizes and is tailored to particular social, cultural, and
linguistic needs.
It follows that, toTo further understand and recognize the importance of cultural competency, in
relation to Aboriginal health, Central West LHIN staff and Board Members and select HSP staff
members have completed the Indigenous Cultural Competency training program offered through
the Provincial Health Services Authority in BC, and have actively taken part in Métis information
and training sessions.
Meanwhile, LHIN CEOs and Aboriginal Health Leads took part in the Provincial Aboriginal LHIN
Network Planning Conference, further establishing strategic priorities to advance Aboriginal health,
the likes of which helped toand inform the development of IHSP 2016-2019.
LHIN CEOs and Aboriginal Health Leads took part in the Provincial Aboriginal LHIN Network
Planning Conference, establishing strategic priorities to advance Aboriginal healthand inform the
development of IHSP 2016-2019.
During 2015/16, the LHIN partnered with the Métis Nation of Ontario (MNO) Credit River Métis
Council and the Mississauga Halton LHIN to hold Powley Day Celebrations at the Island Lake
Conservation area. Thanks to this partnership, voyageur canoe trips and other community health
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activities were provided to as many as 60 participants. It was an excellent opportunity for the MNO
Credit River Métis Council to showcase and support their culture and identity with Métis and nonMétis peoples alike.
The Central West LHIN in partnership with the Mississauga Halton LHIN, the Credit River Metis
Council, the Dufferin County Cultural Resource Centre and the Peel Aboriginal Network held
engagement sessions on the development of IHSP 2016-2019 and discussion paper Patients First:
A proposal to strengthen patient centred care in Ontario. This laid the groundwork for the drafting
of inaugural Terms of Reference for the Central West LHIN and Mississauga Halton LHIN
Indigenous Health Advisory Circle.
Commented [A4]: Revised section from author.
2.4.2 Diversity and Health Equity
Throughout 2015/16, the LHIN’s Diversity and Health Equity Core Action Group continued to
explore and apply effective ways to improve cultural competency and minimize gaps for vulnerable
populations. In partnership with the MOHLTC, Health Quality Ontario (HQO) Regional Diversity
Roundtable, and Peel Newcomer Strategy Group the Central West LHIN identified key areas of
focus including a need to further integrate use of the Health Equity Impact Assessment (HEIA) tool.
HSPs are now using the tool to plan improved access to care for marginalized populations.
Ongoing training is being supported by the LHIN to ensure sustainable and meaningful use of the
tool.
Championed by the LHIN, a host of nine organizations representing primary care, acute care, and
community mental health and addictions services are taking part in a pilot project to collect
sociodemographic information from those who enter and use local health care services.
In 2015/16, all acute and community providers submited progress reports on the implementation of
health equity plans. Submission of yearly progress reports ensures consistent movement towards
the integration of health equity practices, and improvement of equitable access to care.
The Central West LHIN also took a leadership role in developing a pan-LHIN collaborative with the
mandate to discuss local and provincial opportunities that advance the work of health equity and
improve population health for the residents across Ontario.
Building Bridges for
Inclusive Care in Peel
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The Region of Peel was proud to have
been selected as one of 18 Provincial
Service Collaboratives, a key source of
input for years one to three of the
MOHLTC’s ten-year Mental Health and Addictions Strategy. Produced in 2015, the video
Building Bridges for Inclusive Care Care in Peel highlights the coming together of various faith
communities and mental health service providers, to improve recognition of mental health
issues and access to supports by children and youth. And, wWhile the provincial Mental
Health and Additions Sstrategy continues to move forward beyond year three, it is under the
leadership of Punjabi Community Health Services that the work of this collaborative has
continued to make an impact beyond its original mandate.
Partnering for Change
The introduction in 2015 of Partnering for
Change (P4C), a new therapy program
that sends therapists directly into school
classrooms, has been praised by parents
and school officials for giving children with
special needs access to occupational
therapists without having to leave the comfort and convenience of their classrooms.
Originally developed at McMaster University to bring therapy to the children who need it, P4C
is a collaboration with schools, so that teachers can work alongside therapists and learn some
of the therapists’ techniques to help the students on an ongoing basis. Thanks to P4C,
organizers say they have been able to do much more with the same amount of resources.
P4C is now working in more than 60 schools across Peel, Halton and Hamilton-Wentworth.
And more school districts have expressed an interest in adopting the model.
Supporting New Syrian
Canadians
Of the many happenings that captured the
world’s attention in 2015/16, perhaps none
was more compelling that the Syrian
Refugee Crisis. A unifying humanitarian
issue, health care professionals across the
Central West
With a vibrant francophone community, the The Central West LHIN includes a vibrant francophone
community and in 2015/16 continued to work to enable that is looking for better access to local
health care services in French in 2015/16.
Together with LHIN HSPs and Reflet Salvéo, the local French Language Services (FLS) planning
entity, the Central West LHIN ensured the application of an FLS lens to local and provincial
planning including IHSP 2016-19 and Ontario’s Patients First: Action Plan for Health Care. .
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Accordingly, inIn collaboration with HSPs and Reflet Salvéo, – the local French Language
Francophone population, supporting the development and use of common FLS indicators.
The LHIN continued to work closely and collaboratively with Reflet Salvéo, particularly in areas
related to engaging the francophone community, capacity building and service planning. Priorities
and actions were identified and outlined in a Joint Annual Action Plan between Reflet Salvéo and
the Central West, Mississauga Halton and Toronto Central LHINs. Year-end reporting by each
identified for FLS HSPs reported an increase of 34%in the number of Francophone residents who
requested service in French from 2014/15.
The work of the coalition is supported by the Central West and Mississauga Halton LHINs, Reflet
Salvéo and Le Cercle de l’amitié, Well Fort Community Health Services, Oasis Centre des Femmes,
l’Équipe de Santé familiale Credit Valley and le Réseau franco-santé sud de l’Ontario.
for the Francophone
Seniors Coalition
Ongoing development of a collaborative
care project between Reflet Salvéo and the
Central West LHIN continued in 2015/16.
Known as the Coalition pour les aînés
francophones (CAF) de Peel, the CAF
Cercle des Aînés Noirs Francophones de l’Ontario to help address both current and future
service demands for Seniors from a Francophone perspective. Working together as a
collaborative makes it easier for Francophone seniors to become better informed about activities
and services offered to them in the community. It also helps to improve overall service delivery.
2.4.4 Palliative and End-of-Life Care
Made up of all palliative care providers who care for residents throughout the Central West LHIN,
the Central West Palliative Care Network (CWPCN) guided the development of palliative care
services in the Central West LHIN throughout 2015/16, and has been doing so since 2009. These
services are delivered in local hospitals, private homes, LTC Homes, and in one residential and
one community hospice. One adjacent residential hospice and two community hospices also
provide care to residents of the Central West LHIN.
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In 2015/16 the Central West LHIN was proud to take a leadership role in advancing the local
palliative and end-of-life care conversation by futher developing a joint palliative end-of-life care
“Pledge”.
Introduced to over 300 health care profeesionals at the CWPCN Annual Conference, the Pledge is
inspired by a quote taken from the Canadian Hospice Palliative Care Association’s Living Lessons®
report. It reflects a collective commitment to deliver on the promise of providing outstanding
palliative care.
Recognizing a sense of collective responsibility, conference participants shared their "personal
pledge" toward the delivery of outstanding palliative care across the Central West LHIN byposting
their commitments on "pledge boards" placed outside of the main conference hall for public
viewing.
In 2015, the Ministry of Health and Long-Term Care (MOHLTC) announced a major change in the
structure of palliative care networks. A new Ontario Palliative Care Network (OPCN) has been
created, along with a provincial secretariat that will be responsible for providing provincial oversight
of 14 LHIN palliative care networks.
The Central West LHIN recognizes that the delivery of outstanding palliative care is essential for
individuals and families throughout the LHIN’s highly diverse population. While provincially,
Ontario’s palliative care strategy is realigning palliative care networks, locally the Central West
LHIN wants to ensure residents die in a place of their choosing. Accordingly, the LHIN has and will
remain focused on ensuring that... Through a reconstituted CWPCN, the LHIN will work to ensure:
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



capacity is enhanced for palliative care in the home and community
diverse palliative care needs of the community are met
public and health care providers understand options available for palliative and end-of-life care
virtual technology is used as a value-add means to bring care closer to home.
2.4.5 Women and Childrens Health
Throughout 2015/16, the LHIN worked with local providers to improve the quality of, and access to,
women and children’s health services, while at the same time aligning its work with provincial
initiatives. The Central West LHIN worked with the Provincial Council for Maternal Child Health
(PCMCH) to improve access to care for children with medical complexities. The LHIN is also
currently involved in the development of the local Special Needs Strategy for Peel and Dufferin in
alignment with a provincial strategy to improve services for children and youth with special needs in
Ontario. This required collaborating across sectors, working in partnership with with providers
funded by the Ministry of Child and Youth Services (MCYS), Ministry of Community and Social
Services (MCSS), Ministry of Education (MEDU), and MOHLTC.
South Asian Community
Outreach Forum
Hosted by Bethell Hospice, Heart House
Hospice and the Punjabi Community
Health Services the Central West LHIN
was once again proud to be part of the
annual South Asian Community Forum on
palliative and end-of–life care.
The session attracted over 150participants who, through interactive discussions were able to
learn more about what types of palliative and end-of-life services are currently available in their
local communities.
Understanding the important culture-specific aspects of palliative care helps to inform the
planning process in order to create a system that is both patient-centred and responsive to
culturally-specific needs.
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PERFORMANCE
The Ministry-LHIN Accountability Agreement (MLAA), sometimes called the Ministry-LHIN
Performance Agreement, is an agreement between each of Ontario’s 14 LHINs and the
Ministry of Health and Long-Term Care (MOHLTC). It outlines the obligations and
responsibilities of both organizations with respect to the planning, funding and integration
of local health care services.
The MLAA includes measures used to assess the LHINs performance which, from time-to-time, are
modified according to the changing priorities of the health care system. As of fiscal year 2015/16,
the MLAA lists 24 measures in three categories
 Performance: Provincial targets have been established for the 14 performance measures,
based on best practice and clinical evidence where possible. LHINs must report to the ministry
on their performance against these targets on a quarterly and annual basis.
 Monitoring: Provincial targets have been established for some, but not all, of the 8 monitoring
measures. LHINs are not required to report on monitoring measures, but they often provide
important supplemental or explanatory information about the performance measures.
 Developmental: Provincial targets have not been established for the 2 developmental
measures. These measures focus on emerging priorities of Ontario’s health system, and their
definitions are subject to change as they are developed.
Commented [A5]: Introduction rewritten by author.
CENTRAL WEST LHIN MLAA INDICATORS
2015/16 ANNUAL REPORT DATA
Provincial
No.
Indicator
Provincial 2014/15
Most
target Fiscal Year Recent
Result
Quarter
LHIN
2015/16
Result
(ytd)***
2014/15
Most Recent
Fiscal Year
Quarter
Result
2015/16
Result
(ytd)***
1. Performance Indicators
1
Percentage of home care clients with complex needs who received their personal
support visit within 5 days of the date that they were authorized for personal support
95.00%
85.39%
86.55%
85.28%
92.23%
83.58%
88.43%
2
Percentage of home care clients who received their nursing visit within 5 days of the
date they were authorized for nursing services*
95.00%
93.71%
93.21%
93.66%
96.52%
95.19%
95.86%
3
90th Percentile Wait Time for CCAC In-Home Services - Application from Community
Setting to first CCAC Service (excluding case management)*
21 days
29.00
29.00
30.00
19.00
31.00
21.00
4
90th percentile emergency department (ED) length of stay for complex patients
8 hours
10.13
10.48
9.97
10.85
11.25
10.57
5
90th percentile emergency department (ED) length of stay for minor/uncomplicated
patients
4 hours
4.03
4.28
4.07
3.50
3.80
3.68
6
Percent of priority 2, 3 and 4 cases completed within access target for MRI scans
90.00%
41.75%
40.37%
38.41%
25.35%
33.37%
33.34%
7
Percent of priority 2, 3 and 4 cases completed within access target for CT scans
90.00%
77.77%
74.08%
74.60%
79.03%
80.38%
71.51%
8
Percent of priority 2, 3 and 4 cases completed within access target for hip
replacement
90.00%
81.51%
79.63%
79.97%
47.47%
71.76%
67.50%
9
Percent of priority 2, 3 and 4 cases completed within access target for knee
replacement
41 services*
90.00%
79.76%
78.18%
79.14%
47.88%
60.08%
72.19%
10 Percentage of Alternate Level of Care (ALC) Days*
9.46%
14.35%
14.15%
14.16%
7.14%
6.06%
6.02%
11 ALC rate
12.70%
13.70%
14.12%
12 Repeat Unscheduled Emergency Visits within 30 Days for Mental Health Conditions*
16.30%
19.62%
20.33%
13.98%
6.26%
6.00%
5.53%
24.74%
26.09%
25.02%
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Repeat Unscheduled Emergency Visits within 30 Days for Substance Abuse
20.28%
The following section provides an overview of MLAA indicators grouped by which sector of the
health care system they are measuring.
Primary Care
Primary care is the day-to-day healthcare provided by family doctors and other health care
professionals in the community. Primary care measures in the Central West LHIN are included as
monitoring indicators, but do not have target performance associated with them.
Monitoring Indicator #19: Rate of emergency visits for conditions best managed elsewhere
per 1,000 population | Rate of low acuity emergency visits that could be treated in alternative
primary care settings for patients aged 1-74 years. Conditions include:

Conjunctivitis (pink eye)


Upper Respiratory
Infection (cough/cold)

Otitis Media
(earache)
Cystitis (urinary
tract infection).
For patients who are not seniors and have no other complications, the four conditions listed above
are not emergencies and should usually be treated in a setting other than the emergency
department (ED). If patients are arriving at EDs for these conditions, it indicates that these patients
did not have adequate access to primary care, either because they do not have a primary care
provider, because they were not aware of the availability of their primary care provider, or their
primary care provider was not available to them within a reasonable time.
In 2015/16, the Central West LHIN rated best in the province for this indicator, suggesting that
LHIN residents have better mechanisms for dealing with urgent, but non-emergent, health care
issues than most Ontarians.
Monitoring
Indicator #19
Monitoring Indicator #20: Hospitalization rate for ambulatory care sensitive conditions per
100,000 population* | Rate of hospitalization for ambulatory care sensitive conditions per 100,000
population age < 75. Conditions include:
 Grand mal status and other epileptic convulsions
 Congestive heart failure (CHF) and pulmonary edema
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




Chronic obstructive pulmonary disease (emphysema and bronchitis)
Asthma
Diabetes
Hypertension
Angina.
When managed effectively in primary care and/or the community, ambulatory care sensitive
conditions should not lead to hospitalizations. Hospitalizations for these conditions are often
referred to as avoidable hospitalizations and indirectly measure the ability of the health care
system to manage chronic conditions, access to primary care and care in the community.
Optimizing management of these conditions can potentially contribute to both improved patient
health outcomes and more efficient resource utilization.
In 2015/16, the Central West LHIN ranked 4th out of 14 LHINs for this indicator.
Monitoring
Indicator #20
Monitoring Indicator #21: Percentage of acute care patients who had a follow-up
with a physician within 7 days of discharge | Percentage of patients with a hospital
stay for specified conditions who saw their physician within 7 days of discharge.
Conditions include:








Acute myocardial infarction (age 45+) (heart attack)
Cardiac conditions other than heart attack (age 40+)
Congestive heart failure (age 45+)
Chronic obstructive pulmonary disease (age 45+) (emphysema and bronchitis)
Pneumonia
Diabetes
Stroke (age 45+)
Gastrointestinal disease.
Chronic conditions that are not managed appropriately are a cause of substantial avoidable
interactions with the health care system. When a patient with a chronic condition experiences an
exacerbation of that condition, it often requires an ED visit and admission to an inpatient bed. The
combination of appropriate care while in hospital, seamless handoff of care to community
providers, and appropriate follow-up and preventative care in the community can prevent
recurrence of exacerbations and repeated admissions to either the ED or the hospital.
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One of the most important steps in this preventative sequence is connection with the patient’s
primary care provider shortly after discharge from the hospital. In 2015/16, the Central West LHIN
rated best in the province for this indicator.
Monitoring
Indicator #21
System Integration and Access
Performance Indicator #14: Readmission within 30 days for selected Health-Based
Allocation Model Inpatient Grouper (HIG) conditions | This indicator measures what proportion
of patients being treated for chronic disease(s) required subsequent admissions to hospital after an
initial hospital stay. This performance indicator is closely related to the monitoring indicator
immediately above—the chronic conditions being addressed are the same, and follow-up with a
primary care provider after discharge is one of the interventions likely to prevent readmission. In
2015/16, the Central West LHIN ranked 6th out of 14 LHINs for this indicator.
Performance
Indicator #14
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Home and Community Care
To prevent or delay visits to EDs, hospitalizations, and applications to Long Term Care (LTC), and
to enable discharge from hospital, Community Care Access Centres (CCAC’s) provide a variety of
in-home support services in addition to assisting local residents navigate a host of additional
community services. LHINs are measured on the time it takes for a resident to receive CCAC
support services, after having applied for the the service. This period includes both the time from
application to assessment and from assessment to delivery of services.
Performance Indicator #1: Percentage of home care clients with complex needs who
received their personal support visit within 5 days of the date that they were authorized for
personal support services Services provided in the home prevent or delay emergency
department visits and hospitalizations. The provincial access target for the time between when
clients are authorized for personal support and the time that they begin receiving that support is
five days. At a system level, we measure what proportion of the clients receiving services are
receiving them within that provincial target.
In calendar year 2015, the Central West LHIN ranked 6th out of 14 LHINs for this indicator, with
88% of clients receiving their personal support visit within 5 days.
Performance
Indicator #1
Performance Indicator #2: Percentage of home care clients who received their nursing visit
within 5 days of the date they were authorized for nursing services | Services provided in the
home prevent or delay ED visits and hospitalizations. The provincial access target for the time
between when clients are authorized for nursing services and the time that they begin receiving
that support is five days. At a system level, we measure what proportion of the clients receiving
services are receiving them within that provincial target.
At 95%, the Central West LHIN was the only LHIN meeting the provincial target in this indicator
during calendar year 2015.
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Performance
Indicator #2
Performance Indicator #3: 90th Percentile Wait Time for CCAC In-Home Services Application from Community Setting to first CCAC Service (excluding case management) |
The longer a client who needs in-home services at home waits to receive it, the more likely it is that
that client’s condition will deteriorate, and that they will require a visit to the emergency department
and potential hospitalization. The provincial access target for the time between when clients are
authorized for in-home services and the time that they begin receiving that support is 21 days. The
Central West LHIN met this target during calendar year 2015, ranking 5th out of 14 LHINs. An
increase in wait time in the third quarter is reflective of an influx of funding into the system which
allowed a larger number of people to be removed from the waitlist.
Performance
Indicator #3
Health and Wellness of Ontarians...
Mental Health
Visits to hospital EDs may be the appropriate point of access to care for individuals with mental
health and substance abuse conditions who are in crisis. Repeat emergency visits generally
indicate premature discharge or a lack of coordination with post-discharge care and can contribute
to emergency visit pressures.
Given the chronic nature of the mental health and substance abuse conditions, access to effective
community services should reduce the number of repeat unscheduled emergency visits for Ontario
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46
residents. This measure attempts indirectly to measure the availability and quality of community
services for patients with mental health and substance abuse conditions. It also supports the future
development and improvement of data collected that could be used to measure the quality and
availability of community mental health and substance abuse services directly, especially relating
to wait times.
Performance Indicator #12: Repeat Unscheduled Emergency Visits within 30 Days for
Mental Health Conditions | Within this calculation, the MOHLTC considers a repeat visit” to have
occurred every time a patient is transferred from one ED to another. This despite the fact that these
transfers took place within the same “episode of care”, with no opportunity for the patient to receive
community services between the two departments. In-depth analysis at the Central West LHIN
level suggests that when these types of transfers are excluded from the measurement, actual
performance is much better than what is purported by the provincial calculation. More Central West
LHIN residents are receiving the care they need in the community to prevent repeat visits to EDs.
Performance
Indicator #12
Performance Indicator #13: Repeat Unscheduled Emergency Visits within 30 Days for
Substance Abuse Conditions | LHIN analysis shows that patients with substance abuse
conditions are also receiving better services than is suggested by provincial reporting. However,
the difference is not as pronounced as it is for patients with mental health conditions. During the
performance period (January-December 2015) alcohol accounted for more than 80% percent of
repeat visits for substance abuse, and fewer than 30 patients accounted for more than 50% of the
repeat visits.
Performance
Indicator #13
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Wait Times
Wait time indicators measure the proportion of patients who received their surgical or diagnostic
imaging procedures within established provincial access targets. Patients waiting for these
procedures are placed, by their physician, into one of four categories according to how quickly they
need the procedures. LHIN performance is measured for patients in the all but the most urgent
category; Priority I patients are expected to receive services immediately.
Diagnostic Imaging
Performance Indicator #6: Percent of priority 2, 3 and 4 cases completed within access
target for magnetic resonance imaging (MRI) scans| In 2015/16, the Central West LHIN ranked
10th out of 14 LHINs in this indicator, with 33% of patients receiving a diagnostic MRI within the
provincial access targets, 5 percentage points lower than the province as a whole. The LHIN has
neither the physical nor the financial capacity to meet the local demand for MRI scans.
Performance
Indicator #6
target for computerized tomography (CT) scans | In 2015/16, the Central West LHIN ranked 9th
out of 14 LHINs for this indicator, with 72% of patients receiving a diagnostic CT within the
provincial access targets, 4 percentage points lower than the province as a whole.
Performance
Indicator #7
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Surgical Procedures
target for hip replacement | While demand for joint replacement elective surgeries continues to
outstrip funded supply, Central West LHIN hospitals completed all surgeries for which the
MOHLTC allocated funding for in 2013/14. These numbers were not sufficient to clear the wait list.
Performance
Indicator #8
target for knee replacement | As with hip replacement surgeries, the demand for knee
replacement elective surgeries exceeds the supply currently funded by the Ministry of Health and
Long-Term Care.
Performance
Indicator #9
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Monitoring Indicator #15: Percent of priority 2, 3 and 4 cases completed within access target
for cancer surgery | The Central West LHIN missed the provincial target of 90% by only one
percentage point in 2015/16.
Monitoring
Indicator #15
Monitoring Indicator #16: Percent of priority 2, 3 and 4 cases completed within access
target for cardiac by-pass surgery | No hospitals within the Central West LHIN provide cardiac
by-pass procedures. There is no chart for this monitoring indicator.
Monitoring Indicator #17: Percent of priority 2, 3 and 4 cases completed within access
target for cataract surgery | The Central West LHIN missed the provincial target of 90% by only
three percentage points in 2015/16, and completed all funded procedures.
Monitoring
Indicator #17
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Hospital Care
Emergency Department (ED) Length of Stay
Emergency department (ED) indicators measure the length of time from patient arrival at the ED, to
patient discharge from the ED. This measure includes wait time as well as diagnosis, treatment
and monitoring time.
Performance Indicator #4: 90th percentile emergency department (ED) length of stay for
complex patients | Most patients who are triaged as high acuity or who require admission to an
inpatient bed benefit from up to 8 hours in the emergency department. This time is spent being
assessed, treated, and stabilized, and allows the physicians at the hospital to make a decision
about whether the patient can be discharged home or needs to be admitted to an inpatient unit.
After 8 hours, it is more likely that additional time spent in the emergency department does not add
value to the patient’s care, and that if they have not already been discharged home, they would be
better off with the longer-term and more specialized care associated with an inpatient unit.
Central West LHIN performance in 2015/16 missed the provincial target by just under three
hours—this performance is entirely due to the wait time experienced by patients waiting in the ED
for admission to an inpatient unit. The Central West LHIN has the highestproportion of high acuity
ED visits of any LHIN, and the lowest admission rate for high acuity patients. It also has the lowest
ALC rate of any LHIN. However, Brampton Civic Hospital (BCH) consistently experiences both the
highest overall volume of any ED in Canada, leading to a greater need for acute hospital capacity
than exists in the LHIN. Fluctuations in performance indicate the LHIN’s response to and
management of these volumes.
Performance
Indicator #4
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Performance Indicator #5: 90th percentile emergency department (ED) length of stay for
minor/uncomplicated patients | Most patients who are triaged as having a minor or
uncomplicated problem benefit from up to 4 hours in the emergency department. This time is spent
being assessed, treated, and stabilized. After 4 hours, it is more likely that additional time spent in
the emergency department does not add value to the patient’s care, and that at least some of the
time spent in the ED has been spent waiting.
In 2015/16, Central West LHIN length of stay for low acuity patients was third best in the province,
well within the 4-hour provincial target.
Performance
Indicator #5
Alternate Level of Care
When a hospital inpatient has completed her hospital stay, she should be discharged to the next
most appropriate destination for her condition. Alternate Level of Care (ALC) refers to those
patients who continue to occupy hospital beds after they have completed a course of treatment for
which they were admitted and no longer require the care associated with those beds. For a variety
of reasons, these patients experience barriers to discharge from hospital. The patient could be
waiting for a lower level of care within a hospital, or for a lower level of care in the community or
long term care.
Performance Indicator #11: ALC rate | Every hospital bed occupied by a patient designated ALC
is a bed that is no longer included in the overall hospital’s capacity. A patient who is designated
ALC is occupying a hospital bed that, in many cases, is needed by a patient waiting in a different
part of the system, such as the emergency department. Additionally, a day in a higher level of care
costs the system more than a day in a lower level of care. A reduction in ALC days results in more
beds being available for those who need in-hospital treatment and makes better use of health
system resources.
In 2015/16, the Central West LHIN had the lowest (best) ALC rate in the province, keeping the
majority of inpatient capacity in use by patients needing it at the time.
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Performance
Indicator #11
Performance Indicator #10: Percentage of Alternate Level of Care (ALC) Days | All ALC days
are non-value added for the patient; they are pure wait time, during which by definition the patient
is not receiving the care theyneed. In addition, a patient who is designated ALC is in a riskier
environment than necessary (potentially exposed to hospital-acquired infections, not being
activated and socialized). Patients remain in hospital longer than necessary for various reasons,
including room availability in residential facilities, delay’s in discharge, and social and familial
situations. The Central West LHIN had the best performance of all 14 LHINs during the caledndar
year 2015, meaning that patients who were discharged from Central West LHIN hospitals spent
less time waiting for care in their homes, in Long-Term Care or in post-acute beds.
In 2015/16, the LHIN was one of only two LHINs to meet the provincial target for this indicator.
Performance
Indicator #10
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Long Term Care
These measures are indications of the Central West LHIN resident’s experience—how long did it
take for residents to be evaluated for eligibility for care in a Long-Term Care Home (LTCH). 100%
of the time measured for this metric is wait time, and therefore non-value added. The CCAC
determines a person’s eligibility for admission to an LTCH based on parameters and requirements
outlined by the MOHLTC. There are no performance targets for these measures.
Monitoring Indicator #18(a): CCAC wait times from application to eligibility determination for
long-term care home placements: from community setting | Nine out of ten Central West LHIN
residents awaiting assessment in their homes waited up to 16 days for this assessment between
October 2014 and September 2015. The Central West LHIN ranked 8th out of 14 LHINs in this
measure.
Monitoring
Indicator #18a
Monitoring Indicator #18(b): .CCAC wait times from application to eligibility determination
for long-term care home placements: from acute-care setting | Nine out of ten Central West
LHIN residents awaiting assessment in hospital waited up to 12 days for this assessment between
October 2014 and September 2015. The Central West LHIN ranked 12th out of 14 LHINs in this
measure
Monitoring
Indicator #18b
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GAGING LHIN COMMUNITIES
The Local Health System Integration Act (LHSIA) is based, in part, on a belief that the health
care needs of local communities are best understood by those who live and work in them. It
follows that the ability to understand the needs of local Central West LHIN communitiesis
predicated on developing meaningful relationships, in large part through effective
community engagement.
Community engagement itself, is as much about helping LHIN residents to better understand their
local health care system, as it is about listening to their perceptions and needs, empowering them
to be active participants in the planning process.
In 2015/16 the Central West LHIN conducted communications and community engagement
activities with the following objectives in mind:
Business Objectives




Improve access to care
Streamline transitions and navigation of the system
Drive quality and value
Build on the momentum
Communication Objectives



55
Educate and build broad stakeholder awareness of Central West LHIN strategic imperatives
and priorities identified in IHSP 3 (above noted business objectives).
Foster an understanding of the need for continued health system transformation.
Build ongoing support for an integrated sustainable local health care system that places the
needs of patients first, and patients themselves at the centre of their local health care system.
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


Raise awareness of the Central West LHIN’s role, its unique characteristics, value proposition,
caliber and credibility of work, and importance within the local health care system.
Educate and build awareness among HSPs regarding shared accountability for local health
system transformation and the alignment of their respective /initiatives with IHSP 3.
Continue to build strong, trusted relationships with HSP communications teams across the
Central West LHIN, working together to optimize communication resources and coordinated
services.
Throughout 2105/16 the Central West LHIN continued to place an emphasis on the strong,
meaningful relationships it has developed with residents, HSPs, community partners and those
agencies not funded by the LHIN but whose activities contribute to the overall design and
integration of their local health care system. The Central West LHIN executed its communications
and community engagement activities through use of a variety of tools/tactics including…
News Releases
As required, to
highlight/promote Central West
LHIN activities/events.
eNewsletter –
“Working Together
for Healthy
Change”
Monthly electronic periodicals
providing updates on local LHIN
activities, issued to a broad,
general stakeholder audience.
Mid-year
Community Update
Year-to-date progress report to
the community, highlighting
progress made in regard to
IHSP and ABP deliverables.
MPP Meetings
Quarterly face-to-face updates
and information sharing
sessions.
Governance and
Senior Leadership
Forum
Three sessions held in 2015/16
- Two re: IHSP 2016/19
- Patients First
Discussion Paper
Contingent on schedule
availability.
Regional,
Municipal, Civic
Council Meetings
Annual Business
Plan
Published annually.
Annual Report
Published annually for the year
previous.
Board Materials
Posted to Central West LHIN
Website ahead of and following
monthly Board meetings.
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56
Patients First Discussion Paper... join the conversation
With 2015/16 being a year of transition... a year of planning for the future... one of the more notable
engagement initiatives took place in support of the MOHLTC discussion paperIn December 2015,
the MOHLTC released a discussion paper entitled Patients First: A Proposal to Strengthen
Patient-Centred Health Care in Ontario.
In February 2015 the MOHLTC released Ontario’s Patients First: Action Plan for Health Care, the
next phase of Ontario's plan for changing and improving Ontario's health system. Building on the
progress that's been made since 2012 under the original Action Plan for Health Care, it exemplifies
the commitment to put people and patients at the centre of the system by focusing on putting
patients' needs first.
Subsequently, in December, the Ministry released the aforementioned discussion paper, providing
more detail regarding four key components designed to support the next phase of the Ministry’s
plan to reduce structural issues that create inequities. They include:The discussion paper outlined
four key proposals including:




More effective integration of services and greater equity
Timely access to primary care, and seamless links between primary care and other services
More consistent and accessible home and community care
Stronger links between population and public health and other health service.
With release of the discussion paper, the Ministry asked Ontario’s LHINs to assist with stakeholder
engagement, obtaining input regarding the proposals contained within, and advice about how to
further integrate improvements across the health care system.
Recognizing that the health care needs of local communities are best understood by those who live
and work in them, theThe Central West LHIN embraced the Ministry request by conducteding a
series of face-to-face engagement sessions with a variety of stakeholders. The LHINs approach
was to conduct public engagement session in each of the More specifically, invaluable feedback
was on the future of Ontario’s health care system was obtained from residents in each of the
Central West LHIN's five sub-geographic areas, while also conducting targeted stakeholder
consultations with , Aboriginal and Francophone communities, the Central West LHIN Primary
Care Network, and Governors and leaders from HSPs across the LHIN.
Over 300 residents and health care professionals joined in the conversation to be active
participants in shaping the future of their local health care system, their ideas being compiled and
submitted to the Ministry in a comprehensive report of findings.
How are we doing?... resident and HSP satisfaction
In 2015/16, as part of this engagement supported development ofIn developing IHSP 2016-2019,
the LHIN conducted a quantitative telephone studyrandom sample telephone poll to gather
opinions from a representative sample of residents regarding their knowledge, attitudes, and
opinions of the local health care system. It was the fourth such study, building on similar research
conducted in 2006, 2009 and 2013. It also served to validate the priorities and directions
highlighted in IHSP 2016-2019.
57
216
Of note, LHIN residents remain concerned about wait times, as well as the impact of chronic
diseases and an aging population. Of those residents who said that the Central West LHIN is
moving in the right direction, the most common reasons for this response was that health
care/services have improved. Among those who say health care/services have improved, it is
largely attributed to improved access and efficiencies. The highest rated health care service within
the LHIN is primary care. And, LHIN residents hold high expectations of health care services, with
nearly all residents saying they agree with the statement... “the health care system should strive to
provide health care in the home and community, not just in hospitals.”
The Central West LHIN also conducted a third survey of regional Health Service Providers in
2015/16. Once again, the survey was designed to better understand the relationship between LHIN
and local HSPs, as well as how providers feel the region as a whole has moved forward on local
health system priorities.
Survey results were very positive and largely comparable to those obtained in 2014. Health system
funding and planning, along with community engagement are the top three LHIN activities HSPs
placed the most importance on. The LHIN has and continues to build very strong relationships with
HSPs in the region. Consistent with the 2014 survey, quantitative results demonstrated no areas
where respondents felt primarily negative about the LHIN or its efforts. HSPs are aware of, and
understand, the broader health system challenges faced by the LHIN and, while they are of
concern for HSPs they see the LHIN as a partner in addressing those concerns.
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58
The Road Ahead…
Planning for and Realizing the Future.
Capital Investment
Following a number of infrastructure announcements in 2013 and 2014, 2015 saw the
advancement and physical development of a number of important projects, all of which are being
designed with the needs of LHIN residents and patients at their centre.
 Etobicoke General Hospital
William Osler Health System’s Etobicoke General Hospital (EGH) site reached another important
milestone in its redevelopment journey. In November, Osler and Infrastructure Ontario (IO)
announced that the Request for Proposals phase of the project had been closed after a six-month
period. At the writing of this report Osler and IO have since awarded a fixed price contract to
Etobicoke Healthcare Partnership (EHP) to design, build, finance and maintain a new four-storey
wing at Etobicoke General Hospital.
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218
Construction of the new wing is expected to be completed in late 2018. Upon completion, the wing
will add approximately 250,000 square feet of space to the hospital and house the services most
urgently needed by the community it serves including...
-
a larger, state-of-the-art emergency department
Cardiac Care and Intensive Care Units
a Maternal newborn unit with birthing suites and a specialized nursery
a new ambulatory procedures unit
Cardiorespiratory and neurodiagnostic services.
Osler is also planning for the construction of a new ancillary building on the EGH Site. Expected to
begin in May 2016, this building will house a number of outpatient programs and services, including
a fracture clinic, diagnostic imaging, and a satellite dialysis program.
 Peel Memorial Centre for Integrated Health and Wellness
The summer of 2015 saw the “topping off” of the new Peel Memorial Centre for Integrated Health
and construction on this wonderful new facility is progressing steadily.
With completion of the exterior brickwork and penthouse siding, much of the construction activity
moved inside the building, and the signature multi-coloured glass wall in the main lobby is in place,
ready to greet patients and visitors as they enter the building.
Slated for completion in early 2017, Peel Memorial is a new, state-of-the-art hospital that will
provide complimentary services to Brampton Civic Hospital, offering a range of specialty clinics,
day programs and services – from high-tech diagnostics and surgery, to women's and children's
health. Space has also been allocated for education classrooms where patients and family
members will be able to learn from health care professionals about how to take a more active role
in managing their own health.
 Headwaters Health Care Centre
Throughout 2015/16, Headwaters Health Care Centre (HHCC) continued to prepare for its
expansion and renovation project, a significant step forward in increasing access to important
health care services for the growing community.
Addition of the new space is the first major expansion of the hospital since it opened at its current
location in 1997. A new, 8,200 square foot extension will be home to much-needed clinics, services
and programs like chemotherapy, minor procedures, orthopaedics and telemedicine. HHCC is also
taking on an exciting renovation of existing hospital space to add another operating room, improve
reception and expand pre- and post-surgical recovery areas.
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60
 “Building” Healthy Communities
Not only have capital projects progressed at Central West LHIN hospitals, so too have they moved
forward across LHIN communities.
-
WellFort Community Health Centre | Expansion is taking place at the Malton
satellite to accommodate additional programming including primary care, youth
services, oral healthcare, health promotion programs, physiotherapy, and chiropody
and diabetes education.
-
Rexdale Community Health Centre | The Jamestown satellite project will provide
much needs services to the local community including primary care, dental services,
and diabetes education.
-
Rexdale Community Health Centre |The Kipling Dixon proposal will result in
improvements to this existing location, expanding square footage to improve and
enhance program service delivery.
-
Kipling Acres | Redevelopment of Kipling Acres continues following the opening of
Phase 1 in March 2014, representing an initial 192 bed home. Phase 2, currently
under construction an additional 145 beds, is expend to open in 2016.
 Healthy Communities Initiative
Building healthy communities is more than bricks and mortar. Like many communities around the
globe and across Canada, Brampton is addressing a common need, ensuring children, youth,
adults and families are engaged in active healthy living so as to reduce their risk of health concerns
and chronic illness.
In 2015 the Central West LHIN was proud to take a leadership role in the development of the
Healthy Communities Initiative, bringing together community leaders and partners to explore ways
in which to create an active, healthy community, and to develop a plan for getting more PEOPLE,
more ACTIVE, more OFTEN... mentally, physically and spiritually. The Central West LHIN will
continue to take a leadership role in this initiative moving forward in 2016/17.
Patients First and IHSP 2016-19
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220
In 2015/16, there was perhaps no greater example of planning for the future than with the release
of Ontario’s Patients First: Action Plan for Health Care and the subsequent planning and
development of the LHIN’s new Integrated Health Service Plan... IHSP 2016-19.
 Ontario’s Patients First: Action Plan for Health Care
Released by the Minister of Health and Long-Term Care (MOHLTC) in February 2015, Ontario’s
Patients First: Action Plan for Health Care builds on a strong foundation set by Ontario’s original
Action Plan for Health Care in 2012, and strengthens the government’s commitment to put patients
first by improving their health care experience.
While the 2012 Action Plan led to a number of important successes, it has been recognized that
there still exists much work to be done to improve the patient experience, make the health care
system more transparent and accountable, and to ensure the universal health care system will be
there when needed for generations to come.
Ontario’s Patients First: Action Plan for Health Care recognizes the economic and demographic
realities of finite financial resources and a growing and aging population. It also recognizes the
need to approach such realities from a different perspective, where we ask how we can ensure
universality, improve access, and deliver the highest quality of care to people. The answer is a
matter of choice... choice rooted in evidence-based practices; patient experiences; a commitment
to equity, access and universality; and decision making where patients come first.
In planning for the future the Central West LHIN was guided by Patients First in planning and
developing IHSP 2016-19; working to understand and predict the unique needs of people living
within its geography, supporting models that best serve local residents. The development of IHSP
2016-2019 was guided by Ontario’s Patients First: Action Plan for Health Care. Although the LHIN
is not accountable for all of the initiatives identified in Patients First, local priorities and initiatives
outlined in IHSP 2016-19 align with the objectives contained in the plan.
 IHSP 2016-19
IHSP 2016-2019 is the Central West LHIN’s fourth strategic plan. It defines the LHIN’s mission,
vision, values and strategic priorities, outlining how it will go about achieving them. Building on the
momentum of its earlier IHSPs it outlines how together, with HSPs and community partners, the
LHIN intends to plan, integrate, fund and monitor the local health care system. These efforts are
discussed in terms of the LHIN’s Strategic Directions, Initiatives and Actions.
Ambitious yet actionable, and flexible in its ability to adapt to the changing needs of the health care
environment, IHSP 2016-19 is rooted in the common vision and priorities of Ontario’s Patients
First: Action Plan for Health Care, and common objectives of Ontario’s 14 LHINs. It has also been
developed based on an environmental scan of the LHIN, input from community members, client
groups and local Health Service Providers (HSPs), and with guidance from the Central West LHIN
Board of Directors and staff.
Working together, these Directions, Initiatives and Actions establish a comprehensive, focused and
disciplined approach toward the attainment of desired outcomes, and reaffirm the Central West
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62
LHIN’s commitment to put people and patients at the centre of their local health care system… to
improve their health care outcomes and experiences.
To advance the priorities outlined in IHSP 2016-19, the Central West LHIN will continue to focus on
partnerships among patients, caregivers, providers, cross-sector partners and the community at
large. The LHIN will also monitor and report on its progress to the Ministry of Health and LongTerm Care (MOHLTC), and broader community. Through a variety of reports that include the
Central West LHIN’s Annual Business Plans (ABPs) and Annual Reports (ARs), local residents,
patients and providers will have access to up-to-date information about the performance of their
local health care system, and how well the LHIN is progressing with its Strategic Directions.
The Central West LHIN has been a significant driver of healthy change since 2006. Gains that
have been achieved, and those it plans to achieve in the future, are based on hard work by HSPs,
community partners and the LHIN over the past decade.
While the local health care system is further ahead today, much work remains to be done –
particularly in achieving a genuinely integrated health system. IHSP 2016-19 provides the Central
West LHIN with the foundation necessary to meet new challenges and to take a leadership role in
the advancement of high-quality, patient-centred health care across Ontario.
Both residents and health care professionals alike place high value on their health care system,
and the need for it to be responsive to local communities. Accordingly, putting patients first will
remain a shared responsibility as we move forward Together... Making Healthy Change Happen!
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223
64
Insert Audited Financial Statements here
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224
Brampton, ON L6X 4J2
Tel: 905 455-1281 • Fax: 905 455-0427
Toll Free: 1 866 370-5446
www.centralwestlhin.on.ca
ISSN 1913-5718
The Central West LHIN Annual Report 2014/15 is available in both English and French.
225
66
BOARD OF DIRECTORS' MEETING - WED., JUNE 22, 2016 - FIDUCIARY DIALOGUE
Tel: 905 455-1281
Fax: 905 455-0427
Toll Free: 1 866 370-5446
www.centralwestlhin.on.ca
CENTRAL WEST LHIN
2016-2017
First Quarter Report
June 30, 2016
226
8, rue Nelson Ouest, bureau 300
Téléphone : 905 455-1281
Sans frais : 1 866 370-5446
Télécopieur : 905 455-0427
www.rlisscentre-ouest.on.ca
TABLE OF CONTENTS
A – Transmittal Letter................................................................................................................. 3
B – Local Health System Update ............................................................................................... 4
C – Status Update on Special Initiatives..................................................................................... 4
D – Status Update on Integration Activities ................................................................................ 4
E – Quarterly Balance Sheet Forecast Tables............................................................................ 4
F – Sector Forecast ................................................................................................................... 4
G – Report on LHIN Operations ................................................................................................. 4
Attachment 1, CW LHIN – Balance Sheet Forecast for Q1 16-17, June 30
Attachment 2, CW LHIN – Sector Forecast for Q1 16-17, June 30
Attachment 3, CW LHIN – LHIN Operation Forecast for Q1 16-17, June 30
Le RLISS du Centre-Ouest... Favorisons la santé
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227
A – Transmittal Letter
June 30, 2016
MEMORANDUM TO:
Kathryn McCulloch,
Director, LHIN Liaison Branch
Ministry of Health and Long-Term Care
FROM:
Scott McLeod
CEO
Central West LHIN
RE:
2016/17 FIRST QUARTER REPORT
Please accept the attached report on Central West LHIN’s 2016/17 First Quarter
position. It is submitted in accordance with the reporting requirements established in
the Ministry-LHIN Performance Agreement.
This First Quarter Report will be recommended for approval to the Board at the Central
West LHIN’s Finance and Audit Committee meeting of June 20, 2016 and for
subsequent approval by the Central West LHIN Board of Directors on June 22, 2016. A
final and approved version will be submitted to the Ministry of Health and Long – Term
Care by June 30, 2016.
If you have any questions or comments, please contact me at (905) 455-1281 x211.
Sincerely
Scott McLeod
CEO, Central West LHIN
3
228
B – Local Health System Update
As per the Quarterly Reporting Guidelines, updates on the major issues related to the
Central West LHIN’s local health system are only to be completed for the Second
Quarter Report.
C – Status Update on Special Initiatives
As per the Quarterly Reporting Guidelines and direction received from the Ministry of
Health and Long-Term Care (Ministry), status updates on Special Initiatives in the
Central West LHIN are required at the request of the Ministry. The Ministry has not
requested a status update for the First Quarter.
D – Status Update on Integration Activities
As per the Quarterly Reporting Guidelines, updates on the major issues related to the
Central West LHIN’s local health system are only to be completed for the Second
Quarter Report.
E – Quarterly Balance Sheet Forecast Tables
See Attachment 1, CW-LHIN - Balance Sheet Forecast for Q1 16-17, June 30, 2016.
F – Sector Forecast
The Central West LHIN is forecasting a balanced position by year end, 2016/17.
See Attachment 2, CW-LHIN - Sector Forecast for Q1 16-17, June 30, 2016.
G – Report on LHIN Operations
As of Q1 2016/17, the Central West LHIN is projecting a balanced position.
See Attachment 3, CW LHIN - LHIN Operation Forecast for Q1 16-17, June 30, 2016.
4
229
LHIN #: 239_Central West
Attachment 1: 2016-17 Quarterly Balance Sheet Forecast
Purpose:
To collect quarterly balance sheet forecasts information for central agency submission as required by the Treasury Board Secretariat.
Instructions:
1. Please input all values as positives i.e. absolute dollars. Boxes marked grey are formulae which will produce the expected results.
2. Column E: is the 12 months actual for 2015/16. This column should match the March 31st, 2016 audited financial statements
3. Column G: input Q1 estimates for the first quarter (i.e.3 months) of 2016-17 fiscal year.
4. Column I: input the 12 months forecast as at March 31, 2017 for fiscal 2016-17 for Deferred Capital Contributions and
Deferred Operating Revenues only.
5. If you need further clarification, please contact: Tao Qian tel. 416-325-1562, email: [email protected]
Balance Sheet As at:
E
ACTUAL
(12 months)
March 31, 2016
G
Q1 ESTIMATE
(3 months)
June 30, 2016
I
FORECAST
(12 months)
March 31, 2017
ASSETS:
1. Cash
2. Accounts Receivable from:
MOHLTC
Health Service Providers (including Hospitals)
LHINs
Other Govt. Reporting Entities ( excluding Hospitals and
GREs above)
Other Accounts Receivable & Prepaid
Sub-Total
3. Tangible Capital Assets
i. Capital Costs:
a. Beginning Balance
b. In-year additions / (disposals)
c. Ending balance
ii. Accumulated Amortization:
b. less: amortization on disposed assets
c. In-year amortization
d. Ending balance
NET BOOK VALUE (i less ii)
1,251,774
843,193
439,533
68,049
39,903
28,179
114,509
593,945
70,198
166,426
1,107,911
1,107,911
1,107,911
1,107,911
1,069,563
1,090,899
21,336
1,090,899
1,090,899
17,012
17,012
1,862,731
1,026,631
4. All Other Assets:
TOTAL ASSETS
LIABILITIES:
5. Accounts Payable and Accrued Liabilities to:
MOHLTC
624,171
Health Service Providers (including Hospitals)
439,533
LHINs
11,339
Other Govt. Reporting Entities ( Excluding Hospitals and GREs above)
Other Accounts Payable
770,676
Sub-Total
1,845,719
6. Deferred Capital Contributions from the Province (i.e. MOHLTC & Other GREs)
b. In-year Capital Contributions Received/To Be Received
c. Amortization for the Year
d. Ending Balance
7. Deferred Revenue from the Province (i.e. MOHLTC & Other GREs)
b. In-year Contributions Received/To Be Received
c. Recognized in Income for the Year
d. Ending Balance
8. All Other liabilities
TOTAL LIABILITIES
NET ASSETS / (LIABILITIES)
Completed by:
Contact Tel. #:
Date Completed:
230
317,398
1,009,619
-
-
-
-
-
-
-
-
-
17,012
17,012
1,862,731
1,026,631
-
Notes/Comments:
624,172
68,049
-
-
Attachment Two
CENTRAL WEST LHIN QUARTERLY FORECAST BY SECTOR - FIRST QUARTER ($000'S)
(A)
Funding
Allocation (Note
1)
By Sector
(Based on draft
MLPA - May
31/2016 Update)
Operation of Hospitals TOTAL
(B)
In-Year
Adjustments
(Note 1)
530,656.3
Payments to
Government
Reporting
Entity (GREs)
(Note 1)
530,656.27
Grants to compensate for municipal taxation - public hospitals
TOTAL
Long-Term Care Homes TOTAL
156,735.5
156,735.54
Community Care Access Centres TOTAL
-
(D)
Actuals (IFIS) (Note 1)
April to May
(C=A+B)
Revised
Allocation
Payments to
non-GRE
Recipients
89,503.5
(231.0)
0.0
0.0
-
(E)
Estimated June Expenditure (Note 2)
TOTAL
ACTUALS
89,272.5
43,392.0
0.0
26,225.0
26,225.0
114,945.6
114,945.57
0.0
19,246.9
19,246.9
13,620.0
13,619.98
17.4
2,455.2
2,472.6
Assisted Living Services in Supportive Housing TOTAL
11,730.7
11,730.73
0.0
1,781.8
Community Health Centres TOTAL
12,114.2
12,114.21
0.0
2,017.0
Community Mental Health TOTAL
32,452.1
32,452.13
592.2
4,839.1
5,431.3
6,030.8
6,030.83
552.2
453.1
1,005.3
TOTAL
ESTIMATE
43,392.0
-
Community Support Services TOTAL
Addictions Program TOTAL
Payments to
Payments to
Government
non-GRE
Reporting Entity Recipients
(GREs)
(F)
Forecast by Quarter 1 (Q1)
12,958.9
12,958.9
9,489.5
9,489.5
926.0
933.0
1,781.8
1,150.8
1,150.8
2,017.0
1,011.6
1,011.6
292.4
2,389.4
276.0
226.5
7.0
Payments to
Government
Reporting
Entity (GREs)
132,895.5
-
Payments to
non-GRE
Recipients
(231.0)
-
(G)
TOTAL Q1
FORECAST
132,664.5
% Expended Payments to Payments to
to-date
Government
non-GRE
Reporting
Recipients
Entity (GREs)
25.0%
-
132,664.53
-
132,664.53
%
Expended
to-date
50.0%
-
-
39,183.9
39,183.9
-
39,183.89
39,183.89
50.0%
-
28,736.4
28,736.4
25.0%
-
28,736.39
28,736.39
50.0%
3,381.2
3,405.6
25.0%
24.40
3,381.18
3,405.58
50.0%
-
2,932.7
2,932.7
25.0%
-
2,932.68
2,932.68
-
3,028.6
3,028.6
25.0%
-
3,028.55
3,028.55
50.0%
2,681.8
884.6
7,228.5
8,113.0
25.0%
884.56
7,228.47
8,113.03
50.0%
502.5
828.1
679.6
1,507.7
25.0%
828.14
679.57
1,507.71
50.0%
24.4
25.0%
-
TOTAL Q2
FORECAST
50.0%
Acquired Brain Injury TOTAL
-
-
0.0
0.0
-
-
-
-
-
-
-
-
Specialty Psychiatric Hospitals TOTAL
-
-
0.0
0.0
-
-
-
-
-
-
-
-
Grants to compensate for municipal taxation - psych hospitals
TOTAL
-
-
0.0
0.0
-
-
-
-
-
-
-
-
94.2
-
-
794.57
794.57
36.4%
85,965.3
220,366.9
50.0%
Initiatives (Note 3)
2,438.7
2,438.72
94.2
-
TOTAL LHIN
880,724.0
0.0
880,724.0
90,665.3
56,787.1
147,452.3
94.2
94.2
85,033.9
219,666.5
3.9%
-
43,967.4
28,246.8
Note:
1. No input required for Column A, B, C, and D, and these columns are locked.
2. Detail input required for Column E, G, H, and I related to the monthly/quarterly Estimated Expenditure.
3. Actual payments (IFIS) for TP sectors above may include payments related to initiatives.
231
72,214.2
134,632.6
24.9%
134,401.6
(H)
(I)
(J=D+E+F+G+H+I)
Forecast Year-end Position
(J-C)
Variance
By Sector
Payments to
Government
Reporting
Entity (GREs)
Operation of Hospitals TOTAL
132,664.53
Payments to
non-GRE
Recipients
-
TOTAL Q3
FORECAST
132,664.53
% Expended
to-date
75.0%
Payments to
Government
Reporting
Entity (GREs)
132,662.68
Payments to
non-GRE
Recipients
-
TOTAL Q4
FORECAST
132,662.68
% Expended
to-date
100.0%
Explanation of Variance
Payments to
Payments to TOTAL YEAREND
Government
non-GRE
POSITION
Reporting Entity Recipients
(GREs)
530,887.27
(231.00)
530,656.27
-
Grants to compensate for municipal taxation - public hospitals
TOTAL
Long-Term Care Homes TOTAL
-
39,183.89
39,183.89
75.0%
-
39,183.89
39,183.89
100.0%
-
156,735.54
156,735.54
-
Community Care Access Centres TOTAL
-
28,736.39
28,736.39
75.0%
-
28,736.39
28,736.39
100.0%
-
114,945.57
114,945.57
-
75.0%
22.07
100.0%
95.26
Community Support Services TOTAL
24.40
-
3,381.18
-
3,405.58
-
-
3,381.18
-
3,403.25
-
-
13,524.71
-
13,619.98
-
-
Assisted Living Services in Supportive Housing TOTAL
-
2,932.68
2,932.68
75.0%
-
2,932.68
2,932.68
100.0%
-
11,730.73
11,730.73
-
Community Health Centres TOTAL
-
3,028.55
3,028.55
75.0%
-
3,028.55
3,028.55
100.0%
-
12,114.21
12,114.21
-
Community Mental Health TOTAL
Addictions Program TOTAL
884.56
7,228.47
8,113.03
75.0%
884.56
7,228.47
8,113.03
100.0%
3,538.24
28,913.88
32,452.13
-
828.14
679.57
1,507.71
75.0%
828.14
679.57
1,507.71
100.0%
3,312.56
2,718.28
6,030.83
-
Acquired Brain Injury TOTAL
-
-
-
-
-
-
-
-
-
-
Specialty Psychiatric Hospitals TOTAL
-
-
-
-
-
-
-
-
-
-
Grants to compensate for municipal taxation - psych hospitals
TOTAL
-
-
-
-
-
-
-
-
-
-
Initiatives (Note 3)
-
496.65
496.65
56.8%
85,667.4
220,069.0
74.9%
TOTAL LHIN
134,401.6
-
134,397.4
1,053.35
1,053.35
100.0%
86,224.1
220,621.5
100.0%
Note:
1. No input required for Column A, B, C, and D, and these columns are locked.
2. Detail input required for Column E, G, H, and I related to the monthly/quarterly Estimated Expenditure.
3. Actual payments (IFIS) for TP sectors above may include payments related to initiatives.
232
-
537,833.3
2,438.72
2,438.72
342,890.6
880,724.0
-
0.0
CENTRAL WEST LOCAL HEALTH INTEGRATION NETWORK
Attachment 3: LHIN Operations and Initiatives Forecast Q1 16/17
Fiscal 2016-2017
Central West Local Health Integration Network Q1 LHIN Operations Report and Forecast
YTD Budget vs YTD Actuals
Category
SALARY & WAGES
Salaries & Wages
HOOPP
Other Benefits
TRANSPORTATION & COMMUNICATION
Staff Travel
Governance Travel
Communications
YTD Budget June
2016
YTD May 2016
Actuals & June 2016
Forecast
Annual Budget vs Annual Forecast
YTD Variance
Surplus/(Deficit)
Annual Budget
Forecast to Year End
Variance
Surplus/(Deficit)
Variance Explanation
774,319
73,482
80,229
928,030
656,035
65,784
79,864
801,683
118,284
7,698
365
126,347
3,097,275
293,928
320,915
3,712,118
3,097,275
293,928
320,915
3,712,118
-
5,500
3,750
16,500
25,750
1,351
1,142
4,262
6,754
4,150
2,608
12,239
18,996
22,000
15,000
66,000
103,000
22,000
15,000
66,000
103,000
-
57,960
5,000
25
50,795
2,389
1,531
86,258
10,369
12,500
15,500
23,075
7,500
15,000
14,000
301,902
36,037
2,220
21
12,976
805
1,708
86,184
10,391
2,488
13,544
21,672
12,172
3,000
3,624
206,843
21,923
2,780
4
37,819
1,584
(176)
74
(22)
10,012
1,956
1,403
(4,672)
12,000
10,376
95,060
231,840
20,000
100
203,180
9,556
6,125
345,032
41,475
50,000
62,000
92,300
30,000
60,000
56,000
1,207,609
231,840
20,000
100
203,180
9,556
6,125
345,032
41,475
50,000
62,000
92,300
30,000
60,000
56,000
1,207,609
-
6,250
12,069
18,319
3,318
8,252
11,571
2,932
3,817
6,748
25,000
48,276
73,276
25,000
48,276
73,276
-
6,250
6,250
-
6,250
6,250
25,000
25,000
25,000
25,000
-
253,400
5,121,003
5,121,003
-
YTD positive variance due to vacancies in the DRCC Medical Leads positions
*
*
*
SERVICES
Accommodation
Advertising
Banking
Consulting Fees
Equipment Rentals
Insurance
LSSO Shared Costs
LHIN Collaborative
Other Meeting Expenses
Board Chair's Per Diem expenses
Other Board Members' Per Diem expenses
Other Governance Costs
Printing and Translation
Staff Development
SUPPLIES & EQUIPMENT
IT Equipment
Office Supplies & Equipment
MINOR CAPITAL ASSETS
Minor Capital Assets Purchased
TOTAL LHIN OPERATIONS, DRCC, ER/ALC
1,280,251
1,026,850
* Expenses expect to be higher in Q3 & Q4 based on past experience
233
YTD positive variance due to $20K cheque for settlement of Insurance Claim related to flood
*
Consulting projects planned for Q2 - Q4
*
YTD negative variance due to G2G in April
*
*
Expect to spend in Q4
Attachment 3: LHIN Operations and Initiatives Forecast Q1 16/17
Fiscal 2016-2017
YTD Budget vs YTD Actuals
Category
YTD Budget June
2016
YTD May 2016
Actuals & June 2016
Forecast
Annual Budget vs Annual Forecast
YTD Variance
Surplus/(Deficit)
Annual Budget
Forecast to Year End
Variance
Surplus/(Deficit)
Variance Explanation
ABORIGINAL COMMUNITY ENGAGEMENT
1,875
1,875
-
1,875
1,875
7,500
7,500
7,500
7,500
-
26,500
26,500
24,621
24,621
1,879
1,879
106,000
106,000
106,000
106,000
-
18,750
18,750
18,000
18,000
750
750
75,000
75,000
75,000
75,000
-
18,750
18,750
18,000
18,000
750
750
75,000
75,000
75,000
75,000
-
18,750
18,750
18,000
18,000
750
750
75,000
75,000
75,000
75,000
-
105,750
130,500
236,250
42,754
134,065
176,819
62,996
(3,565)
59,431
423,000
522,000
945,000
423,000
522,000
945,000
-
Expenses expected to occur for Q2 - Q4
FRENCH LANGUAGE SERVICES
*CRITICAL CARE LEAD
*ED LEAD
*PRIMARY CARE LEAD
E-HEALTH
** CW LHIN
** PROJECT MANAGEMENT OFFICE
TOTAL LHIN INITIATIVES
GRAND TOTAL
320,875
255,440
65,435
1,283,500
1,283,500
-
1,601,126
1,282,290
318,835
6,404,503
6,404,503
-
* Funding has not been confirmed/received
** Budget amounts reflect current year CW LHIN managed funds - balance of cluster funding to be distributed to other LHIN's
234
E-health projects planned for Q2 - Q4
Central West LHIN I RLISS du Centre-Ouest
CEO ATTESTATION 2016-2017
—
1ST
Quarter (QI)
Prepared in accordance with section 14 of the Broader Public Sector Accountability Act, 2010 (BPSAA)
To:
The Board of the Central West Local Health Integration Network (the “Board”)
From:
Scott McLeod, Chief Executive Officer
Date:
Re:
CEO Attestation for the 1st Quarter (QI) of 2016-2017 (April 1, 2016 to June 30, 2016)
the “Applicable Period”
On behalf of the Central West LHIN (the LHIN) I attest to:
•
•
•
•
•
the completion and accuracy of reports required of the LHIN, pursuant to section 5 of the BPSAA, on the use of
consultants;
the LHIN’s compliance with the prohibition, in secon 4 of the BPSAA, on engaging lobbyist services using public
funds;
the LHIN’s compliance with all of its obligations under applicable directives issued by the Management Board of
Cabinet;
the LHIN’s compliance with its obligations under the Memorandum of Understanding with the Ministry of Health
and Long-Term Care; and
the LHIN’s compliance with its obligations under the Ministry LHIN Accountability Agreement/Ministry LHIN
Performance Agreement in effect,
during the Applicable Period.
In making this Attestation, I have exercised care and diligence that would reasonably be expected of a Chief Executive Officer in
these circumstances, including making due inquiries of LHIN staff that have knowledge of these matters.
I further certify that any material exceptions to this Attestation are documented in the attached Schedule A.
‘óntario
If.two.k
k4.
d.,wvku d. ,.eti
235
Dated at Brampton, Ontario on Wednesday, June 15, 2016.
ot McLeod
C e Executive Officer
Cen al West Local Health Integration Network
I hereby certify that this Attestation has been approved by the Board of Directors of the Central West Local Health Integration
Network.
Maria Britto
Chair, Board of Directors
2
236
SCHEDULE ‘A’ TO CEO ATTESTATION
For the Applicable Period 2016/2017 1St Quarter (Ql)
(April 1, 2016 to June 30, 2016)
—
Note to LHIN Boards re Schedule A.
If the LHIN has no exceptions to declare, please insert “no known exceptions” under each of following below:
1.
Memorandum of Understanding
No known exceptions.
2.
Ministry-LHIN Accountability Agreement (MLAA), Ministry-LHIN Performance Agreement (MLPA) in effect
3.
Completion and accuracy of reports required pursuant to Section 5 of the BPSAA;
EXCEPTION:
The LHIN has determined that the terms and conditions on which all fourteen LHINs acquired insurance breach the LHINs’
obligations under LHSIA, the Financial Administration Act, the MOU and possibly the MLPA. The LHIN is endeavouring to
resolve this accidental breach by seeking approvals required by LHSIA, the Financial Administration Act, the MOU and the
MLPA. This process began with a submission by Toronto Central LHIN, on behalf of all LHINs, to the Ministry of Health
and Long-Term Care (the “Ministry”). The LHINs await a response from the Ministry.
4.
Prohibition, in section 4, of the BPSAA, on engaging lobbyist services using public funds;
5.
Compliance with applicable directives issued by the Management Board of Cabinet (including Procurement,
Travel, Meals and Hospitality, and Perquisites Directives)
3
237

Meeting Materials - Central West LHIN

Transcription

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