Our report to the community

Central East Community Care Access Centre

2013-2014 Outstanding Care Partner

Outstanding Systems Partner

Outstanding Place to Work

The Central East CCAC ....................................... 22013-2014 Facts and Stats .................................... 3

Message from the Board Chair and CEO .................. 4

Outstanding Care Partner .................................... 5

Patient Stories .................................................. 8 Finding hope through the CCAC - Sidney’s storyMHAN helps student overcome consequences of traumatic experience – Sarah’s storyCCAC provides tailored care, respite, and peace of mind

Outstanding Systems Partner ............................... 15 Assisted Living for High Risk SeniorsCentralized Diabetes Intake

Central East LHIN Self-Management Program Community engagement eReferral to LTCHealth Links in the Central EastIV Therapy in Long Term Care HomesMedical Supplies Physiotherapy reform

Outstanding Place to Work ................................... 22

Story in numbers .............................................. 24Feedback improves excellence in care ...................... 26Statement of Operations .................................... 28

Contact us ...................................................... 30

Table of contents

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Our Values:CaringWe relate to each other, to those we serve and to those with whom we work with compassion, respect, integrity and fairness and value the contribution of everyone.

Excellence We base our decisions on ethical principles and best available information and our actions on best practice.

Centred on the PatientWe encourage and promote personal responsibility and informed and participative decision-making.

CollaborationWe co-ordinate our efforts, working in partnership with colleagues, patients, families, caregivers, providers and the community.

Accountable We manage resources responsibly, share performance related information freely, and foster a culture of open communication.

Continuous Improvement As a learning organization, we foster a spirit of inquiry, committed to improving understanding and encouraging innovation.

Our Vision:Outstanding care -

every person, every day.

Our Mission: To deliver a seamless experience through

the health system for people in our diverse

communities, providing equitable access, individualized care coordination and

quality health care.

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The Central East Community Care Access Centre (CCAC)

Central East

du Centre-Est

Beverley Dew, Chair

Jamie Marcellus, Vice-Chair

Joseline Sikorski, Treasurer

Helen Briggs

Patrick Connolly

Nicola Crow

Susan Donaldson

Liz McCreight

Rick Morphew

Dr. Barry Neil

Glenn Rogers

Andy Williams

Central East Community Care Access Centre

(CCAC) Board Members:

Facts & Stats - April 1, 2013 - March 31, 2014

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Serves an area of over

16,673 sq. km.

with

1.6 million residents

9 hospitals

operating out of

15 sites

138 Community

Support Agencies

68 Long-Term Care

Homes with

9,529 beds

7 Family Health

Teams,

8 Community

Health Centres9

School Boards and

2 Children’s Treatment Centres

Spent approximately

$700 thousand

each day

43,917 patient transfers were made from hospital to home

Assessed

7,066 people for

Long-Term Care placement and facilitated the placement for

2,723 individuals

43,550 visits

were made to our Alternate

Care Settings for nursing care

Provided

2,603 palliative

patients with in-home end of life care

Provided

12,207 children with School Health

Support Services

CENTRAL EAST AREA PROFILE HOW WE HELPED

Connected

7,795 patients to a Primary Care

Provider through the Health

Care Connect Program

Centralized Diabetes

Intake Care Coordinators

referred

656 patients to Diabetes Education

Programs andthe Centre

for Complex Diabetes Care

80,434patients

served annually

In our patient and caregiver survey conducted from a random selection of the 80,000 plus patients who receive services from the Central East Community Care Access Centre (CCAC), 92 per cent told us they were satisfied with the care they are receiving.

Throughout this Annual Report to the Community, testimonials from some of those patients, caregivers, family members and health care partners, provide some insight into the impact our care has had on the lives of those we are privileged to serve. That said, we continue to seek ways to hear the patient voice and improve on our ongoing programs and services based on this important feedback.

Again this past year, our organization has continued to seek opportunities to collaborate with health and community partners to identify innovative and quality-based initiatives that will provide the expected outcomes and an outstanding experience for our patients and their caregivers. Several of those initiatives are reflected in this report.

Central East CCAC employees provide the foundation on which we continue to build our efforts to deliver outstanding care to every person, every day. But we cannot do it alone and to recognize the dedication and commitment given by the caregivers in our community, we introduced our first Heroes in the Home event to celebrate these unrecognized heroes. A total of 128 deserving individuals were nominated and received certificates of recognition and appreciation across the Central East region.

Throughout the year we began the work to achieve the goals of our three 2013 - 2016 Strategic Directions: Outstanding Care Partner, Outstanding System Partner and Outstanding Place to Work. We have adapted our structure to implement the new provincial Client Care Model, knowing that with this change, the attention of Care Coordinators can be more focused on sub-populations, thus enabling them and us to provide improved care to those patients.

We have brought new approaches to our wound care program and have carefully examined the use of our medical supplies and equipment in our Alternate Care Settings, our hospitals and at our branches. We have

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Message from the Board Chair and CEO

introduced many new programs or enhanced others, including, the Rapid Response Nurses program, the Mental Health and Addictions Nurses in schools program, the Nurse Practitioner Supporting Teams Averting Transfers (NPSTAT) and Community Palliative Care Nurse Practitioner (CPCNP) and the Self-Management Program.

We are committed to ensuring we are accountable in our appropriate use of public funds and we are pleased to report that the Central East CCAC ended the 2013 – 2014 fiscal year in a balanced budget position.

Over the past several years, the debate about the complexity of the health care system and how it should be effectively managed and funded has continued. These important discussions add great value to thinking about the future of our health care. The Ontario Association of Community Care Access Centres published four Health Comes Home papers this past year, that are designed to spark important conversations about some of the issues identified. We have taken the ideas contained in these documents into consideration as we have implemented our programs and services.

Throughout all of our activity during the year we continued to recognize the valuable role of Care Coordination. It remains a critical and important clinical role that skilled and trained health professionals bring to the coordination and provision of care provided to patients in our communities. This important navigation role often has been seen and recognized as one of the missing pieces in our complex health system, a role that aids those in our system access to clinical expertise that provides support and encouragement as well as knowledge and access to the system designed to meet their needs.

As this report will show, each day we strive to find the balance of achieving the right outcome and providing the right experience, knowing that if we do so, we will be successful in meeting the needs of those we are privileged to serve, in a caring, positive and fiscally responsible manner.

Beverley Dew Donald M. Ford CHAIR, BOARD OF DIRECTORS CHIEF EXECUTIVE OFFICER

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As an Outstanding Care Partner the Central East CCAC engages patients, caregivers and partners in the coordination of quality home and community care that promotes independence, drives optimal health outcomes and delivers a positive experience for our patients.

During the 2013 – 2014 fiscal year, Central East CCAC continued to experience a high demand for the traditional home care services including nursing, personal support, physiotherapy and occupational therapy primarily targeted to increasingly complex patient populations.

In addition, CCACs are increasingly being asked to take on more non-traditional home care services that require the skills of specialized nurses. These nurses provide direct clinical care such as those who work in the Ministry mandated Rapid Response and Mental Health and Addictions programs.

Outstanding Care Partner

Nurse Practitioners (NPs) have also become an integral part of the delivery of clinical care in the CCAC sector helping to address the increasingly complex health care needs of CCAC patients, such as NPs who work in the Central East Community Palliative Care Nurse Practitioner program and those who provide support in the Central East LHIN’s Long-Term Care Homes (LTCH).

Behavioural Supports Ontario Behavioural Supports Ontario (BSO) enhances services for older people with responsive behaviours linked to cognitive impairments, people at risk of the same, and their caregivers. The goal of BSO is to provide those individuals with the right care, at the right time and in the right place (at home, in Long-Term Care or elsewhere).

Funded by the Central East LHIN, the Central East CCAC provides staffing resources to support the BSO program including Quality Improvement Facilitators. In its second year of operation, with funding provided by the Central East LHIN, 50 new front-line staff were hired to help increase in-house behavioural supports in LTCHs across the region.

An estimated 2,400 front-line LTCH staff have received specialized training in techniques and approaches applicable to behavioural supports and quality improvement.

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Surveys and feedback from the LTCHs indicate they are seeing a reduction in responsive behaviours, improved resident quality of life, increased behavioural management skills and increased staff confidence related to behavioural supports for these complex residents.

Some successful strategies that have helped with behaviour management:• Introducing a book, a listener and a routine, helped a retired history teacher recall past career skills • Visual cues with way-finding and labels throughout the home increased the capabilities of an independent lady and helped to decrease striking out at caregivers • The creation of personalized invitations for a “spa day” in a bath, twice a week, assisted with meeting personal hygiene needs for a woman who refused to shower for four months.• The iPod with jazz music transitioned restless, grabbing and crying behaviours in a former jazz performer into continuous singing and increased participation in care tasks.

“There is an abundance of positive effects Behavioural Supports initiative has exposed me to. It is changing the culture of care

delivery through education and person-centered care!” BSO LTCH NURSE

Home FirstSustaining the Home First philosophy at the 15 hospital sites across the Central East LHIN region, this fiscal year saw 30,417 patients who were transitioned from hospital to home or a LTCH with the support of the CCAC and community support services.

Nurse Practitioners in LTCH Nurse Practitioners Supporting Teams Averting Transfers (NPSTAT) provides on-site clinical support for acute and episodic changes in the condition of LTCH residents. There are 11 NPs supporting 61 LTCHs in the Central East region. Through the work of the NPSTAT, more than 95 per cent of LTCH patients have been diverted from local emergency departments.

Nursing Initiatives: Mental Health and Addiction NursesThe Mental Health and Addiction Nurses (MHAN) program in collaboration with the four District School Boards across the Central East region, provide a dedicated team of Mental Health Nurses to help respond to mental health

“The NPSTAT program has been a wonderful addition to our

overextended medical community. The ability of nursing staff to call a Nurse Practitioner to visit the Long-

Term Care Homes (in our community) during office hours has significantly

improved access to care for our nursing home patients and reduced

unnecessary hospital transfers. I trust this excellent program will continue

to be funded and provide its essential medical service for this vulnerable

patient population.”CENTRAL EAST FAMILY PHYSCIAN

“Thank you for partnering with us in our team’s efforts to help patients with the enrollment process to get a family doctor. Your expertise and friendly disposition

were key to the success of our efforts to inform local residents that we are currently accepting patients and help them register. We regard you and Health

Care Connect partners in the truest sense of the word and are very proud of the relationship we enjoy and the results we have accomplished together.”

EXECUTIVE DIRECTOR, FAMILY HEALTH TEAM

O U T S TA N D I N G C A R E PA RT N E R

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“Thank you for your thoughtful e-mail message regarding how well your late wife was cared for by Community Care Access Centre nurses and personal support workers. It’s heartening

to know that your wife was so well looked after in the later stages of her life and I’m very pleased

to hear that she received such excellent home care from a great team of caregivers, as well as such

compassionate palliative care from the Northumberland Hills Hospital

during her last days.”THE HONOURABLE DEB MATTHEWS – MINISTER OF HEALTH

and addiction issues of students and their families from Kindergarten to Grade 12. The MHAN program supports students who are discharged from hospital with their transition back into school and their community.

Since the program began in March 2013, 1,155 students have been referred, have received service and/or mental health and addiction information from the MHAN program. Sarah is one student who received help from a Mental Health and Addiction Nurse and shares her story on page 10 of this report.

Important Facts: • 70 per cent of mental health problems and illnesses begin during childhood or adolescence.• Anxiety disorders are the most common among children and youth with the median age of onset being 6 years of age and 11 years for behaviour disorders, 13 years for mood disorders and 15 years for substance use disorders.• Approximately 25 per cent of students with a psychiatric disorder drop out of school• Suicide is the second leading cause of death, after accidents among 15 to 19 year-olds.

“This letter is to acknowledge the dedication and compassion that the CCAC Care Coordinator has given to the patients on the

medical/psychiatry unit of the Rouge Valley Health System. She was an avid advocate for the patients and their families and

handled herself in a professional and respectful manner.”STAFF AT ROUGE VALLEY HEALTH SYSTEM

Rapid Response NursesThe Rapid Response Nurses (RRN) program was introduced in early 2013 and is now available in all nine hospital corporations across the Central East LHIN. The goal of the RRN program is to ensure a smooth and safe transition from hospital to home for patients of all ages with complex needs and their families.

This service sets the foundation for ongoing integrated home care provided through the Central East CCAC and its service providers. The RRN supports initial home transition by confirming the patient’s discharge plan, initiating communication with the patient’s primary care provider or specialist and ensuring a follow-up appointment is booked, as well as reviewing the patient’s medications.

There have been 1,561 referrals since the initiation of the RRN program.

“From a Home First perspective, the RRN service helps to prevent unnecessary Emergency Room visits, and/or hospital admissions.”

CENTRAL EAST CCAC CARE COORDINATOR

Speech Therapy Clinics Increased Central East CCAC Speech Therapy clinics were introduced through the School Health Support Services program to help facilitate the assessment of more children who were in need of Speech Language Therapy. Since the beginning of the year, 403 children were assessed at the clinics.

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frightening out of body experiences and issues with coordination, which force her to spend up to five hours a day in a wheelchair.

Recently, Sidney has also begun to suffer from what Ginette refers to as clusters of seizures.

“They’ll happen at any time” says Ginette, “they can happen when she’s walking, when she’s sleeping, when we’re driving the car. If they don’t stop in a certain amount of time or if she’s turning blue too often, we know to call 911.” These episodes, which can last up to three hours, Ginette says and can have a devastating effect on Sidney. She loses consciousness and will experience partial paralysis on her left side for several hours.

“They (Occupational and Physiotherapists) showed us how to take her up the stairs and down the stairs, how to get her in the tub and how to get her out of the tub, how to get her in the car and get her out.” The Physiotherapist also showed Ginette some methods to ensure Sidney gets some exercise even while in her wheelchair in order to avoid the loss of strength and muscle mass.

Ginette shared with Caroline, the Central East CCAC Care Coordinator assigned to Sidney’s case, that she was having challenges working with the school to get Sidney the support she needed in the classroom. In response, Caroline attended meetings with the school alongside Ginette

Finding hope through the CCAC - Sidney’s story

Ginette had all but given up hope that her daughter Sidney would be able to return to school when a chance encounter with an Occupational Therapist (OT) from a Central East CCAC service provider changed everything.

Having just stopped by to deliver Christmas cards to the same school she had to pull Sidney out of a month earlier, Ginette found the classroom empty but for one person. That individual introduced herself as Shannon an OT, and, having watched Ginette struggle to assist Sidney into the room, asked if there was anything she could do to help. In response to this simple offer, Ginette burst into tears and proceeded to tell Shannon about the incredible struggles her family had faced in caring for Sidney.

Nineteen-year-old Sidney suffers from Polymicrogyria, a condition characterized by abnormal development of the brain before birth. As a result of her condition, Sidney has not advanced beyond the mental capacity of a 3-year-old and she suffers multiple debilitating seizures a day. In an effort to control and reduce the effects of her seizures, Sidney is required to take extremely high doses of four to five different anti-seizure medications, which sometimes leave her quite ill and she also experiences significant side effects from the medication including

Patient Stories

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in order to advocate for Sidney and ensure the appropriate resources were put in place to allow for her safe return to school, including adequate Educational Assistant (EA) support and a special bus to transport Sidney to and from school in her wheelchair.

“I don’t think I could have got through it without Caroline. There was so much disappointment, so many doors slamming in my face,” says Ginette. “She’s the one who helped me persevere through all of this, it was like she held my hand through it all.”

Caroline ensured the therapists visited the school to show the EA how to effectively support Sidney in the classroom. Ginette explains, “They showed the EAs how to bring her to the washroom and what to do if she has a seizure.

“Sidney absolutely loves her PSWs, they’re her friends,” she says, adding that she is so appreciative of the personal support service, “the PSWs just giving her a bath is a huge relief for me. So now for a couple hours during the week and on the weekend, Steve and I can actually go out, or go for a walk and we feel that she is safe.”

Recognizing that Sidney was not the only one who required support, Caroline also helped to link Ginette with mental health services in the community. “She gave me a lot of clarity; she gave me a lot of direction. I can’t thank her enough,” said Ginette.

In February 2014, Sidney was able to begin the transition back into school and is now attending regularly. Ginette is passionate in her appreciation for the CCAC and particularly for Sidney’s Care Coordinator. “If it wasn’t because of Caroline, I don’t know what would have happened past last December,” she recalls. “I don’t know what I would have done. I can’t begin to express how much she’s taken off my shoulders.”

Fighting back tears, Ginette recalls, “That day that Caroline came for the home visit in December, it was the first time in a long time I felt like somebody knew. She could understand. For the first time in a long time I felt like I was almost validated, like someone knew for sure what we were going through.”

“I just want to give a shout out to the Central East CCAC Care Coordinator for providing me with

such great support and suggestions with my mom being a new CCAC patient. Her professionalism

and understanding certainly reflected this agency’s commitment to helping the community.”

DAUGHTER OF CENTRAL EAST CCAC PATIENT

PAT I E N T S T O R I E S

Theresa added that Sarah missed a lot of school to attend appointments and because of illness. The Social Worker at the school told Sarah and Theresa about the Mental Health and Addictions Nursing (MHAN) program offered through the Central East CCAC.

The MHAN program is a provincial tri-ministry joint initiative funded by the Ministry of Health and Long-Term Care, the Ministry of Education and the Ministry of Children and Youth Services and supported by school boards across the province. The program consists of a dedicated team of Mental Health Nurses who provide support to students struggling with mental health and addictions issues and to those transitioning from hospital back to school. In the Central East region, four of the five district school boards work collaboratively with the CCAC (students in Scarborough from the Toronto District School Board and the Toronto Catholic School Board fall under the Toronto Central region).

Once Sarah was connected with Darcy, her Mental Health and Addictions Nurse, she began to show signs of improvement.

“In the beginning she taught me about the symptoms I was having and why I was having them,” recalled Sarah. “And then we moved on to talk more about my thoughts and my feelings and how they were affecting my behaviour towards things.

“She also gave me some coping skills to help me get through my days and make everything a bit easier on me.”

Theresa recalled the relief she felt at seeing signs of improvement in Sarah. “You could see things changing incrementally,” she said. “For a long time I was afraid to leave her alone. I wouldn’t go out for the evening, but the coping skills made it so I could go out and not worry so much.”

After she was violently attacked by a group of girls on two separate occasions, Sarah began to experience symptoms of anxiety that eventually began taking over her everyday life. Forced to quit her dream summer job at a marina in cottage country where she was staying with her grandparents, Sarah returned home and spent most of the remainder of the summer in her bed.

“I had stopped wanting to see my friends, I had stopped going to parties, I had stopped wanting to be in public,” recalled Sarah of the initial stages of her anxiety. “It just led to everyone not talking to me because I never came around.”

Sarah’s symptoms continued to worsen over a three-month period. “Eventually it led to me not wanting to get out of bed, not eating, I wasn’t communicating with any of my friends, there was just no will to do anything, I was always tired, I always wanted to sleep, I was always angry at people. I was just always worried about things” she said.

At her lowest point, Sarah left her home one morning in her pyjamas and bare feet. Fearing she may be capable of self-harm, her mother, Theresa, called the police for help. Sarah was picked up and admitted to hospital for observation. Theresa worried that Sarah would face a future of being in and out of mental health institutions and surrounded by mental health practitioners. “She just wasn’t herself,” Theresa recalled of that difficult time. “As a parent I knew my daughter was sick, but it wasn’t something with a cure so precise as a surgery or a specific medication.”

When school started in September, Sarah began missing classes on a regular basis and her grades started to slip. “My attendance and academics were affected hugely because of the issues I was going through,” she recalled.

MHAN helps student overcome consequences of traumatic experience – Sarah’s story

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Both Sarah and Theresa felt that the accessibility of the program was very important to Sarah’s success. Mental Health and Addictions Nurses are able to meet with patients in a variety of settings including the school. “The Mental Health Nurse came to the school resulting in fewer absences,” said Theresa. Sarah was able to leave class to meet with Darcy and then return to class right after.

“It’s great to have it in the school. It’s convenient,” said Theresa.

Sarah credits the rapport she built with Darcy as an important factor towards her recovery. “I think I have a great relationship with my nurse” she said. “We were able to get along and we were able to talk about things. It gave me the motivation to want to get better and to actually do the things she was asking me to do.”

Darcy taught Sarah a number of coping strategies to help manage the symptoms of her anxiety. Sarah would listen to music, practice

deep breathing, and spend time with her dog Winston, taking him for walks and playing with him.

Sarah’s feelings towards school changed significantly after working with Darcy. “Now my feelings towards school are really good and really positive” she said. Originally, due to the extent of the mental health issues she was experiencing, Sarah did not have any plans to apply for post-secondary education after graduating from high school.

“When it came time to go to college I didn’t think I would be able to go, as a matter of fact I didn’t even think I was going to graduate Grade 12,” said Sarah. However, thanks in part to the intervention of the MHAN program and the improvements that Darcy helped to facilitate in Sarah, her feelings on the subject of college shifted. Sarah applied to and was accepted at three colleges. She has opted to attend a French college when she completes her high school education.

Mental Health & Addictions Nursing Program

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PAT I E N T S T O R I E S

When Joyce was admitted to the GAIN clinic it was identified during a conversation with the NP that she had stopped taking her thyroid medication. Immediately, the NP tested her thyroid levels and they were dangerously low.

“I had heard about the GAIN clinic through the CCAC Care Coordinator and wanted my mom to go in there. Within a week (of discussing it with the Care Coordinator), she got into the GAIN clinic and by that afternoon she was in respite care – it was that quick. I really believe that if my mom hadn’t gotten into the GAIN clinic to be assessed she wouldn’t have lasted the year, she was spiralling down so fast,” recalls Susan.

Since Joyce’s decline in health, William has been her primary caregiver.

“I help my wife with anything she needs or wants. If she wants a glass of water, I get it. If she wants to get out of bed, I help her out of bed. I even have to help her in and out of the washroom,” says William.

When Joyce was discharged home from respite care, the Central East CCAC Care Coordinator assessed Joyce’s health care condition to determine if personal support hours were required. Although Joyce and William initially did not want any help, they eventually realized they were having difficulties managing on their own.

William says he is grateful for the personal support hours Joyce receives. “This is enough time for me to get to a doctor’s office, pay some bills or go to the grocery store or whatever needs to be done,” he explains. “Whether the Personal Support Worker (PSW) is here or not, it still has to be done, so this helps me a great deal.”

The role of a caregiver is not one that William is accustomed to and one that his daughter has concerns about.

“I am not only concerned about my mom, I am concerned about my dad too because he is not used to providing care and he has some limitations himself,” explains Susan.

CCAC provides tailored care, respite, and peace of mind William and Joyce have been married for over 60 years, have two grown children and still live in the home where they raised their family.

“We’ve lived together for so long we wouldn’t know what to do without each other,” says William.

When Joyce’s health started to deteriorate dramatically in the fall of 2013, her family was very concerned.

“She was so weak, her hair was falling out, she couldn’t move her legs, stand or walk and she couldn’t put a sentence together. We were watching her deteriorate over a couple of months,” recalls Susan, William and Joyce’s daughter.

After being seen in the emergency department at the hospital for her failing health, Joyce was referred to the Geriatric Assessment and Intervention Network (GAIN) clinic for assessment and treatment.

The GAIN clinic is part of a broad system of services designed to ensure better outcomes for frail seniors 75 years or older. The clinic aims to provide comprehensive inter-professional and senior friendly geriatric assessment and appropriate interventions to eligible seniors; to increase capacity for GAIN clients to remain in the community; to reduce potentially avoidable emergency department visits and hospital admissions; and, to improve integration of services between GAIN Clinics within GAIN hospital sites, with the Central East CCAC, primary care providers and mental health care sectors.

There are four GAIN clinics located at the largest community hospitals within the Central East region - Lakeridge Health (Oshawa), Peterborough Regional Health Centre, Rouge Valley Health System (Centenary Site) and The Scarborough Hospital (General Campus). Each GAIN clinic is operated by an inter-professional team that includes a: Central East CCAC Care Coordinator, Nurse Practitioner (NP), Occupational Therapist, Physiotherapist, Geriatrician and physician support, Pharmacist and Social Worker.

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“Please let me express deep appreciation for your professionalism, care and patience regarding my

parents. Since my father’s stroke, our family faced new and great challenges. Your professional experience

helped us to understand how to face and handle the sudden change of my father’s physical health. Your

sincere caring, prompt action and responses reduced my family’s fear and stress.”

DAUGHTER OF CENTRAL EAST CCAC PATIENT

The personal support care hours they receive helps to provide assistance in laundry, light cleaning, meal preparation, bathing, and toileting for Joyce as well as caregiver relief for William.

“I am thankful for the service from the CCAC because if I wasn’t getting help, I would have no free time to myself. It’s quite surprising how much energy it drains out of you taking care of somebody, especially when you have never done it before. Now I have more respect for the PSWs as they come to our house for a couple of hours and then go to someone else’s house for a couple of hours – their entire day is helping people,” says William.

In addition to the PSW service, the CCAC Care Coordinator also arranged for an Occupational Therapist (OT) to visit Joyce in her home to assess for safety and risk concerns. The OT provided additional support by bringing in equipment: blocks to raise Joyce’s chair to a height that would make it easier for her to sit down and get back up again, a raised toilet seat and handles for the toilet to assist with easier dexterity, and a wheelchair and walker to help with mobility issues.

With the help of the GAIN clinic providing the initial assessment and treatment of Joyce’s thyroid condition, the daily assistance from the PSW and the safety equipment provided by the Occupational Therapist, the CCAC effectively coordinated care that was tailored to helping Joyce regain strength and independence, while providing much needed relief for William and peace of mind for Susan.

“Our CCAC Care Coordinator is not only there to give us information but she really does seem to care. I think the CCAC is doing an amazing job,” says Susan.

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“A big thank you for a lovely Heroes in the Home celebration. I will always remember how special you

made me feel.”HEROES IN THE HOME RECIPIENT

“Thank you and all the wonderful people who were responsible for the beautiful reception given for the

awards presentation night, Heroes in the Home. I surely did feel special.”

HEROES IN THE HOME RECIPIENT

“We thank you for your kindness toward the care of our father. Thanks for setting up home care and for your understanding and compassion.”

FAMILY OF CENTRAL EAST CCAC PATIENT

“You and your organization were invaluable to my wife and myself during this long ordeal.”

SPOUSE OF CENTRAL EAST CCAC PATIENT

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As an Outstanding Systems Partner the Central East CCAC has pledged to actively contribute to an integrated and sustainable health system by expanding partnerships, embracing leading practices and innovation and achieving value for money.

During the past year, the Central East CCAC introduced and continued to develop several innovative integration partnerships resulting in better efficiencies for all partners involved. Working with our health system partners provides the foundation for successfully meeting the goal of ensuring that patients and caregivers get the best quality of care possible while meeting our obligation to balance our budget. The following are just a few examples of our successful partnership initiatives.

Assisted Living for High Risk SeniorsAssisted Living for High Risk Seniors aims to enable people to maintain their independence and to remain in their homes, for as long as possible without requiring institutionalization. The program provides personal support, homemaking, security checks and reassurance on a 24/7 as needed basis.

The Central East CCAC in collaboration with our community partners, Community Care Durham, Carefirst Seniors and Community Services Association, Community Care City of Kawartha Lakes, Victorian Order of Nurses and Yee Hong Centre for Geriatric Care has been working together to identify high risk seniors whose needs cannot be met in a cost effective manner through home and community care services provided solely on a scheduled visitation basis.

With the support of the Central East LHIN, new and expanded hubs were initiated in early 2014 in Scarborough, Whitby, City of Kawartha Lakes, Havelock, Campbellford and Cobourg. Approximately 150 Central East patients have been transitioned to the new hubs.

Outstanding Systems Partner

“I seldom have the opportunity to share positive feedback on a colleague. However, the Central East CCAC Care Coordinator stands out in my mind as an exceptional communicator. She is

a professional. She listens to her patients and their families. It is comforting to have someone with her knowledge, passion for her

role and ability to expedite patient flow.” UNIT CLERK – ROUGE VALLEY HEALTH SYSTEM

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One of the goals of the Central East CCAC is to be an outstanding system partner - to collaborate with our

community partners as well as expand on these partnerships. In my role as a Point of Access Care Coordinator,

I often rely on my community partnerships and through this collaboration we have been able to reach improved health

outcomes for patients and improved quality of life for patients and their families.

CENTRAL EAST CCAC CARE COORDINATOR

“Thanks for your dedication, patience and professionalism. You really make a great difference in assisting seniors who require your services.”

CENTRAL EAST CCAC PATIENT

Centralized Diabetes IntakeIn support of the Ontario Diabetes Strategy to improve care for Ontarians living with diabetes, stakeholders in the Central East region are working together to develop initiatives including the establishment of a more streamlined and integrated service for the intake and referral of people living with or at risk of developing diabetes.

The Central East CCAC has been providing Centralized Diabetes Intake (CDI) to the three care delivery sites of the Central East Centre for Complex Diabetes Care (CCDC) since August 2012.

Beginning in December 2013 and using a phased-in approach, the CDI extended to include Diabetes Education Programs (DEPs) as another point of access to diabetes care and services across the region.

The CDI Care Coordinators determine eligibility, provide the patient with options for DEPs and, based on the patients’ needs and preferences, the patient chooses the location of the program they wish to attend. In addition to the DEPs and the CCDC, where appropriate, the CDI Care Coordinators also provide access to many other services including:• Regional Cardiovascular Rehabilitation and Secondary Preventative Service• Community Care Access Centre • Community Support Services• Health Care Connect• Central East Self-Management Program

When fully utilized, CDI will help to decrease emergency department visits and hospital admissions for people living with diabetes. A single dedicated phone number (1-888-997-9996), along with a referral fax number, (905-444-2544), is available to access CDI across the Central East region.

O U T S TA N D I N G S Y S T E M S PA RT N E R

17

In the Central East region, admission to the Centre for Complex Diabetes Care (CCDC) is facilitated by the Central East CCAC. The CCDC operates from three care sites located at, Lakeridge Health, Peterborough Regional Health Centre and The Scarborough Hospital and augments the care already provided by Diabetes Education Programs, primary care providers, diabetes specialists and other diabetes programs by addressing the unique needs of people with diabetes with complex needs.

A new patient came into the Lakeridge Health CCDC site for an initial consult appointment. During the assessment with the Registered Nurse (RN) a serious wound was identified placing the patient at high risk for infection and/or loss of the limb.

The patient refused to go to Emergency Room (ER) and was very emotional with fear of losing yet another limb.

The CCDC team mobilized into action. Supplies were obtained by the Registered Dietician so that the RN could dress the wound; the Social Worker worked with other patients and helped with faxing information and obtaining forms for referrals; the Endocrinologist completed an urgent referral for community services; the RN left a message for the family physician updating on the patient’s status and need for immediate medical intervention and need for wound specialist appointment; the RN also contacted the Central East CCAC to ensure the patient received immediate in home nursing services.

The family physician connected with the RN and immediately sent a wound specialist referral and also stated that she will call the patient at home to encourage a visit to the ER. The family physician called the RN at the end of the day to thank the CCDC team for the exceptional care her patient received as well as the follow up with her so that she could

intervene in a timely manner. The quick action and intervention on the part of the CCDC team resulted in the patient receiving much needed medical attention and likely the prevention of the loss of the limb.

Mr. B is a 65 year-old patient who was seen at the Peterborough Regional Health Centre CCDC site. He had poorly controlled Type 2 diabetes and was challenged with neuropathy and a foot ulcer for over 10 years which limits his mobility. Mr. B was forced to take an early retirement from his work in Toronto and decided to settle in Peterborough. He has been jobless since and, along with his growing health problems, he was struggling financially.

Over a few months, Mr. B worked with the inter-professional team at the CCDC site to optimize his medications as the oral medication was not effective. Initially he was reluctant to start insulin but with appropriate education, he was agreeable to insulin therapy. His diabetes management has demonstrated significant improvement with no issues with hypoglycemia and his blood pressure is on target. Mr. B reported that he has more mobility and energy. Through his recent changes and counseling from the CCDC inter-professional team, he reports he feels much better and is motivated to find a job.

Mari is so pleased with the care she receives from The Scarborough Hospital Centre CCDC site that she recommends it to everyone she knows with diabetes. She even advises her doctor to refer his other patients.

“It’s fabulous having everyone in one place,” says Mari. “People with diabetes don’t just have one problem, they have many and the CCDC addresses them all.”

She adds that another benefit of all her appointments being in once place and on the same day saves her time, money and pain spent on public transit.

“I can’t walk very far anymore because my legs get so sore,” she says. “So taking the bus to only one appointment in one place is wonderful. I don’t know what I did before this place.”

Mari has been attending the CCDC for almost one year and has seen improvements in her eating habits, exercise routine and overall health.

Mari’s story is reprinted with permission from The Scarborough Hospital

CCDC success stories

18

Central East LHIN Self-Management Program The Self-Management Program completed another successful year providing workshops to aid adults with a chronic condition to grow their skills, knowledge, tools and confidence to self-manage their day-to-day behaviours to support healthy choices while living with the challenges of having a chronic disease.

In addition to the Self-Management team achieving targets for the number of workshops delivered, they also connected with a variety of populations in Central East communities, established new partnerships with hospitals, organizations and health care provider agencies.

The team continues to sustain existing partnerships through follow-up activities and mentorship opportunities. Highlights included the new interactive mentorship webinars for Choices & Changes graduates that provide more in depth application of behaviour change principles and, “Living a Healthy Life” workshops hosting graduate refresher sessions in Scarborough, Durham and the North East areas.

The successful completion of 80 six-week “Living a Healthy Life” workshops, as well as 31 Choices & Changes: Clinician Influence Patient Action health care provider workshops, is evidence of a strong commitment by the Self-Management team to deliver their programs across the Central East region.

O U T S TA N D I N G S Y S T E M S PA RT N E R

Community engagement

Throughout the 2013-2014 fiscal year, the Central East CCAC Community Education and Outreach team continued their work to develop connections and engage with community partners and the general public.

Working with other health care agencies and community support services through community partner networks provide opportunities for integration and collaboration as well as support system partnerships.

New partnerships developed during the year included the Health First Committee at the Ross Memorial Hospital, Northumberland Hills Hospital Community Partner Network, Caring for Aging Relatives Group (CARG) and Toronto Alzheimer Society’s Community Network. As well, the outreach to the Chinese and Tamil communities in Scarborough continued to expand during the year with 18 presentations and information sessions.

The Central East CCAC was a participating partner on a subcommittee of the Haliburton County Service Provider Network that developed and initiated the successful Haliburton Highlands Community “Need to Know” Education Series promoting health, wellness and information about community support services.

Community Education and Outreach staff participated in 440 events during 2013 -2014 including, 92 presentations, 72 displays, 40 community engagement activities and 236 networking activities across the Central East region. Through these activities and dissemination of Central East CCAC material, over 20,000 individuals in the region learned about CCAC services.

“On behalf of my whole family, I would like to express our deepest gratitude for all of your help rendered to my father

and mother over the past few years.”SON OF CENTRAL EAST CCAC PATIENTS

19

Health Links in the Central EastA growing body of evidence suggests that health system problems people encounter, and the lack of progress on improving outcomes for our neediest patients, is likely to increase if action is not taken. The Ministry of Health and Long-Term Care (MOHLTC) reports that five per cent of patients account for two-thirds of health care costs. These are most often patients with multiple, complex conditions. Health Links was introduced by the Ministry with the view that when the hospital, the family doctor, the long-term care home, community organizations and others work as a team, the patient receives better, more coordinated care.

Health Links is an integration strategy to enhance care for complex patients, where providers in the community: primary care, specialists, hospitals and Community Care Access Centres (CCAC) are charged with coordinating care plans at the patient level. It is a philosophy

that provides an opportunity for integration that can improve patient outcomes as well as system efficiency and is dependent on the voluntary participation from providers involved in the care of the high user patient group.

Funded by MOHLTC through the Central East LHIN, seven Health Links are planned for the Central East region. The Central East CCAC was selected as the administrative lead for Health Links in the region and a quality improvement approach will guide the planning, design and implementation.

The Peterborough and Durham North East Health Links are currently implementing a process for coordinated care plans with patients as well as increasing access to primary care providers. The Northumberland, Haliburton and Kawartha Lakes and Scarborough North and South Health Links are in the early stages of primary care engagement and assessment of their readiness to proceed.

eReferral to LTCThe Central East CCAC’s project to automate the referral process to Long-Term Care Homes (LTCH) began in February 2013 with 12 partner LTCHs in the Port Hope, Lindsay and Haliburton branches. Further implementation of the eReferral to Long-Term Care (LTC) followed in the Peterborough, Whitby and Scarborough branches.

eReferral to LTC provides both the Central East CCAC and our partner LTCHs with a consistent business process and a standard application and referral package for anyone applying for LTC programs. As well, it promotes an increase in the administrative efficiency and facilitates a smoother transition for individuals to LTCHs.

This initiative builds on a solid partnership between the CCACs and LTCHs that use the knowledge and resources of each organization to provide high-quality patient care. The Central East CCAC currently has 60 homes utilizing e-Referral.

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O U T S TA N D I N G S Y S T E M S PA RT N E R

IV Therapy in Long-Term Care HomesAt the request of the Central East Home First Oversight Steering Committee, a project team was created to develop a model of care specifically for patients requiring Infusion Therapy (IV) in LTCHs.

The Central East CCAC Infusion Therapy Committee proposal identified an enhanced process that would meet the needs of frail elderly patients, allowing them to remain safely at home for the duration of their IV treatment. The goal of this initiative is to support LTCHs in the Central East region in the delivery of complex IV services for residents. The project will allow for timely transitions from hospital to home and will also help to avoid hospital readmissions.

Beginning in March 2014, the Central East CCAC embarked on a nine-month Proof of Concept initiative in collaboration with Nurse Practitioners Supporting Teams Averting Transfers (NPSTAT), contracted nursing service provider, St. Elizabeth Health Care, infusion therapy vendor, Bayshore Specialty Rx Pharmacy and six LTCHs in the Central East region. Throughout the duration of the pilot, data will be collected in order to measure the effectiveness of the initiative.

Improving the overall health status and quality of life of LTCH residents requiring IV therapy through a coordinated seamless care experience is the ultimate goal of the IV Therapy in LTCH model of care.

“My wife passed away recently having suffered breast cancer for many years. Because she was bedridden and too weak to get around it was arranged for the CCAC to come and help.... Many people in Ontario are always wondering where

their tax dollars go, well this is where they go, and I think the CCAC should be praised for the work that they do. At home with us was where my wife wanted to be, and we were there when she left us.”

HUSBAND OF A CENTRAL EAST CCAC PALLIATIVE PATIENT (Excerpted from a letter to the editor)

“Thank you for the care I received

from the nurse. I found him to be

caring, competent, communicative

and committed to learning. He is a good role model

for nursing in these challenging times.”

CENTRAL EAST CCAC PATIENT

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Physiotherapy reformOn April 18, 2013 the Minister of Health and Long-Term Care announced the government would expand access to publicly funded physiotherapy, exercise and falls prevention classes in communities across Ontario. As part of this expansion, Community Care Access Centres would become the single point of access for in-home physiotherapy services across the province.

The Central East CCAC viewed the expansion as an opportunity to revise their existing physiotherapy model, which focused on short-term acute patients, to also encompass patients with high needs related to chronic conditions with complicating factors, frequent falls and/or a recent decline in an ability to perform an activity of daily living.

In collaboration with contracted therapy service providers, the Central East CCAC developed a model of care that is goal-directed and addresses the needs of both short-term and longer-term patients. In addition, a standard set of outcome measurements was developed to determine the frequency of service required and to ensure a standardized approach to assessing and monitoring a patient’s progress.

Medical Supplies improvementsIn 2013, the Central East CCAC, in collaboration with contracted nursing service providers, undertook a review of the organization’s medical supplies ordering process which resulted in an improved patient experience while gaining significant cost savings.

Six new standard medical supply kits for hospital and in-home services were developed by the review committee, including a car kit for visiting nurses to use in urgent situations. The kits can be sent home with the patient from the hospital, arranged for delivery to the patient’s home by the Care Coordinator, or brought directly to the home by the visiting nurse. Each kit is tied directly to a patient to facilitate tracking and costing of supplies.

In addition to the creation of standard kits, new guidelines were introduced related to order maximums, order frequency and delivery codes to allow for fast-tracking authorization, making the process much more efficient. Inventory control guidelines were introduced for Central East CCAC Alternate Care Settings (ACS) and hospital and regular audits are performed to ensure supplies are appropriately stocked at all times.

The results so far have indicated significant success in the changes introduced to the medical supplies ordering process, including in the first three months of implementation, a decrease in the average monthly supply cost per referral from $204.50 to $149.30.

“I cannot believe how quickly things fell into place when we needed them to. Many times we run the healthcare system down,

but it is times like this that we learn how lucky we are.”SPOUSE OF CENTRAL EAST CCAC PATIENT

22

Building on the strengths, expertise and leadership capacity of our employees to drive excellence and continuous improvement in a healthy, safe and energized workplace, the Central East CCAC strives to be an Outstanding Place to Work.

Outstanding Place to WorkEmployee EngagementEvery three years CCAC employees are provided the opportunity to participate in a common Employee Engagement Survey conducted across all 14 CCACs in the province.

Five hundred Central East CCAC employees, representing 60 per cent of staff, responded to the 2013 survey. A comparison of the results from the previous survey showed significant positive increases in all areas measured. Teams of Central East CCAC employees continue to work on the results of the survey striving to find ways to continue to improve on our overall experiences.

Employees are actively engaged on other volunteer committees that help to promote work life balance and wellness. The participation in the Peterborough and Scarborough Branches’ United Way campaigns are examples of popular and successful fundraising activities where employees annually raise funds for area programs and services supported by United Way.

The Central East CCAC Summer Family Picnic, Holiday Dance and the Holiday Family Party are among the annual events organized by the volunteer-run Events Committee for employees and their families with fundraisers held throughout the year to support these activities. Additional events such as the baseball and hockey tournaments help to promote social and inter-branch interaction, enhance work-life balance and promote physical, mental and social well-being throughout the Central East CCAC.

To view our video on being an Outstanding Place to Work, please visit: http://youtu.be/ugb_C8xM2II

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“We sincerely want to thank you for helping us so much during the illness. The help just appeared so quickly.”

SPOUSE OF CENTRAL EAST CCAC PATIENT

Recognizing exceptional effortsThe Central East CCAC hospital Care Coordinators, Team Assistants and their management team at the Ross Memorial Hospital (RMH) in Lindsay were awarded the James Ross Award of Excellence in the Community Category in early 2014.

The award is the highest honour bestowed by RMH and acknowledges individuals or groups in the community whose exceptional efforts have made a positive impact on the hospital’s patients and staff. In recognition of the Central East CCAC’s team contributions, the hospital’s award committee said, “Without them the Hospitalist department would be lost. They help speeding up discharges thus improving our length of stay; they are always there for us, providing us with excellent family histories, etc. Well done!”

Improving employee wellnessThe Central East CCAC commitment to providing our employees with an environment where they can access opportunities to improve their health was the impetus behind a collaboration between the Central East CCAC Workplace Health and Safety program and the Central East LHIN Self-Management program (a program hosted and run out of Central East CCAC).

A voluntary pilot workshop for employees, “Living a Healthy Life with Chronic Conditions” was developed to provide support, skills and resources to employees living with chronic conditions.

This innovative approach to supporting employee wellness and the success in making a positive difference for employees was featured in the Ontario Occupational Health Nurses Association Spring/Summer journal.

To read the article, visit: http://healthcareathome.ca/centraleast/en/news/Documents/OOHNA_Journal_Spring_Summer_2014.pdf

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Client Services Individuals Served and Percentage DistributionAPRIL 01, 2013 - MARCH 31, 2014

SERVICE 2013-2014 2012-2013

Visiting Nursing

Personal Support

Occupational Therapy

Physiotherapy

Speech

Nursing Clinic

Social Work

Nutrition

Shift Nursing

23,391

21,704

19,317

12,665

3,259

4,239

1,105

710

298

23,284

20,706

18,059

9,509

2,928

3,622

1,234

886

296

Our story in numbers

“Thank you to CCAC for their patience and understanding and

to the occupational therapist (OT). Without the amazing

knowledge and dedication of the OT, it would have been

impossible to make the transition into a new wheelchair. The OT’s

expertise and understanding was invaluable. She is a true

professional.” CENTRAL EAST CCAC PATIENT

“Many thanks for all the assistance and TLC given to me by your amazing PSWs

these past two months. I am so grateful your services were

available as I recovered.”CENTRAL EAST CCAC PATIENT

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Client Services Units Provided and Percentage DistributionAPRIL 01, 2013 - MARCH 31, 2014

SERVICE 2013-2014 2012-2013

Personal Support Visiting Nursing Shift Nursing Nursing Clinic Occupational Therapy Physiotherapy Speech Social Work Nutrition

2,780,796

553,688

224,139

43,550

68,092

102,150

15,029

4,308

2,239

Client Services Total Expenditures ($) and Percentage BreakdownAPRIL 01, 2013 - MARCH 31, 2014

SERVICE 2013-2014 2012-2013

Personal Support Visiting Nursing Shift Nursing Nursing Clinic

Occupational Therapy

Physiotherapy

Speech

Social Work

Nutrition

82,817,297

32,814,933

11,549,880

2,118,924

8,336,898

6,449,655

1,966,755

452,516

251,902

84,395,012

34,263,811

11,285,010

1,913,797

8,113,641

4,226,377

2,018,030

516,314

275,979

2,833,282

566,632

218,088

38,950

67,030

42,408

15,533

4,638

2,890

(M=million)

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SOURCE OF COMPLIMENT FEEDBACKAPRIL 01, 2013 - MARCH 31, 2014

Client Family/Caregiver Employee Service Provider Community Partner Hospital Staff Physician Client Advocate Other Third Party Political Office Self-Management Program member

One way the Central East CCAC understands how it is achieving its vision of Outstanding Care Every Person Every Day, is to randomly survey patients and/or caregivers on a quarterly basis. The Central East CCAC, along with the other CCACs in the province, utilize the services of an independent company NRC Picker Canada or one of their designated sub-contractors, to conduct the survey. The results of the survey help the CCACs identify strengths and opportunities for quality improvement initiatives.

Based on the survey results during the 2013-2014 fiscal year, 92 per cent of patients and caregivers reported they were satisfied with the overall care and services they received from the Central East CCAC.

Fiscal Year 2013-14 2012-13Compliments 133 138Inquiries 89 90Complaints 19 316

Compliments from families, caregivers and patients focused on Service Quality of our service providers and our staff, specifically their attitude, courtesy, communication and/or explanation of the care plan with patients and families.

Inquiries from elected official constituency offices made up 67.4 per cent of the total number of all inquiries to the Central East CCAC. The majority of questions referred to wait times for service or accessibility to service.

The three main complaint issues identified were:• Service Quality (28.7 per cent) related to the coordination of care of Service Providers and/or the CECCAC staff quality of care and the technical skills of our service providers; • Communication (20.8 per cent) complaint issues were related to explaining or informing patients or caregivers of their care plan; • Service issues (17.5 per cent) were primarily about quantity of service received by patients and wait times for service.

Feedback improves excellence in care

27

SOURCE OF COMPLAINT FEEDBACKAPRIL 01, 2013 - MARCH 31, 2014

Family/Caregiver Client Political Office Independent Complaint Facilitator Action Line Ticket Employee Client/Caregiver Survey Service Provider Client Advocate Community Partner Other Third Party Physician LHIN Hospital Staff Retirement Home Self-Management Program member

SOURCE OF INQUIRY FEEDBACKAPRIL 01, 2013 - MARCH 31, 2014

Political Office Other Third Party Family/Caregiver LHIN Employee Client Action Line Ticket Service Provider Client/Caregiver Survey Client Advocate

“I am moved to write this letter of appreciation for the services I received from the CCAC ACS

clinic at the Scarborough North site. All the nurses were friendly and good but one (in particular) never takes short cuts because of lack of time and he is very punctual, imparts good sound

common sense knowledge and takes pride in his work. He constantly adjusts the dressing, care and evaluations according to the healing process. He is equitable and respectful in his approach to all

patients.”CENTRAL EAST CCAC

ACS SCARBOROUGH NORTH CLINIC PATIENT

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2013-2014 2012-2013 $ $

REVENUESFunding from Central East Local Health Integration Network (LHIN)/Ministry of Health and Long-Term Care (MOHLTC) 248,397,476 240,194,112 Service revenue - LHIN programs 824,400 824,400Interest 282,881 98,051Other income 658,594 487,295Amortization of deferred capital contributions 624,575 574,718Amortization of deferred lease inducements 228,740 228,740Amortization of deferred donations - 11,113Total Revenue 251,016,666 242,418,429

EXPENDITURESSalaries, wages and benefits 75,581,239 66,309,482Contracted out services 162,954,370 163,777,436Administrative costs 7,457,522 7,245,419Occupancy costs 4,063,220 4,006,224Amortization of capital assets 853,315 814,568Total Expenditures 250,909,666 242,153,129 Excess / (deficiency) of revenue over expenditures 107,000 265,300

The Statement of Operations presented has been extracted from the complete audited financial statements of Central East Community Care Access Centre for the year ended March 31, 2014.

Statement of Operations

29

“We thank you for your kindness toward the care of our father.

Thanks for setting up home care and for your understanding

and compassion.”FAMILY OF CENTRAL EAST

CCAC PATIENT

“You and your organization were invaluable to my wife and myself

during this long ordeal.”SPOUSE OF CENTRAL EAST

CCAC PATIENT

30

Campbellford ............................... 705-653-1005 119 Isabella Street, Unit 7, Campbellford ON K0L 1L0

Haliburton ................................... 705-457-1600 PO Box 793, 13321 Highway 118, Haliburton ON K0M 1S0

Lindsay ........................................ 705-324-9165 370 Kent Street West, Lindsay ON K9V 6G8

Peterborough ................................ 705-743-2212 700 Clonsilla Avenue, Suite 202, Peterborough ON K9J 5Y3

Port Hope ..................................... 905-885-6600 151A Rose Glen Road, Port Hope ON L1A 3V6

Scarborough ................................. 416-750-2444 100 Consilium Place, Suite 801, Scarborough ON M1H 3E3 Chinese Line .................................... 416-701-4806

Whitby ......................................... 905-430-3308 920 Champlain Court, Whitby ON L1N 6K9

Toll free: ................................... 1-800-263-3877

TTY Line: .................................. 1-877-743-7939

Website: www.healthcareathome.ca/centraleast/

Wherever you live in Ontario, to find health care and community-based services, call 310-2222 or visit www.centraleasthealthline.ca.

Central East CCAC Branch Offices

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York Region

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Central East CCACScarboroughBranch Office

Contact Us

“Thank you for all your support and help with my grandmother. By

getting her admitted to palliative care in Lakeridge,

she was able to live out her last few weeks under supervision and

dignity. She passed away surrounded by her family- free of pain and fear. I will

always remember how you helped us get her into the hospital when she was

under duress.”GRANDDAUGHTER OF

CENTRAL EAST CCAC PATIENT

TheCentralEastCCAC

@CECCAC

www.healthcareathome.ca/centraleast