Engaging with Local Health Integration Networks

Jill Tettmann, CEO North Simcoe Muskoka LHINChantale LeClerc, CEO Champlain LHIN

Family Service Ontario Conference 2015“Moving Forward Together”

May 5th, 2015

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Overview of Session

• What is a LHIN

• Single-Session Intervention in the Champlain and NSM LHINs

• Working with your local LHIN

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Local Health Integration Networks

Regionalization of Health Care in Ontario

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What is a LHIN?Devolving health care decision-making to the local level

• In 2005 Ontario moved to a regionalized healthcare model, recognizing that a community’s health needs are best understood by people who live there

• LHINs are not-for-profit crown agencies responsible for planning, integrating and funding local health services in 14 geographic areas of the province

• LHINs are now accountable to the Ministry of Health and Long Term Care for over $23B in annual funding

• Unlike other provinces in Canada, local health service provider boards have been maintained

• LHINs replace the 16 District Health Councils and 7 Regional Offices of the Ministry of Health

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• Establishes 14 LHINs and defines their structure, powers and board composition

• Outlines LHINs’ responsibilities for planning, funding and community engagement

• Specifies the LHINs’ integration powers including:

• Providing a definition of integration and describes types of integration

• Outlining the shared responsibility of LHINs and health service providers to identify opportunities to integrate the health system

Local Health System Integration Act (2006)Creating the Legislative Framework to for a more Integrated System

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LHIN Geographic Regions

LHIN Regions:1 . Erie St. Clair2. South Ouest3. Waterloo Wellington4. Hamilton Niagara Haldimand Brant5. Central West 6. Mississauga Halton7. Toronto Centre8. Centre9. Central East10. South East11. Champlain12. North Simcoe Muskoka13 .North East14. North Ouest

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LHIN Mandate

Planning

Community Engagement

Financing and

Allocations

Accountability and

Performance Management

Integration and Coordination

LHIN Funded Health Service Providers

• Hospitals

• Community Care Access Centres

• Community Support Services

• Mental Health and Addictions Services

• Community Health Centres

• Long Term Care Homes

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Programs Not Funded by LHINs

• Ontario Health Insurance Program (OHIP), including physician fees

• Clinics, ambulance services and laboratories

• Provincial programs such as Cancer Care Ontario and the Ontario Renal Network

• Capital for hospital and community investments

• Provincial drug programs

• Most primary care providers, including Family Health Teams and other inter-professional teams

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3 Levels of the Ontario Health SystemLHINs role in the provincial accountability framework

Ministry of Health & Long Term Care

LHINs

Health Service Providers

• Sets provincial standards, policy, provincial direction and priorities• Holds LHINs accountable through performance agreements and MOU• Retains responsibility for funding models & LHIN funding envelope

• Plan and manage the local system, aligned to provincial priorities • Hold local providers accountable through Service Accountability Agreements,

performance management and monitoring, funding • Provide leadership for local integration

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• Manage own operation and plan within the LHIN context

Single-Session Interventions

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The Champlain LHIN

• Easternmost region

• 18,000 square kilometers

• 1.2 M people

• 20% francophone

• 3% Aboriginal

• 18% immigrant

• 20% of Champlain residents live in a rural community

• Large border with province of Québec

• 176 accountability agreements for health services12

• A network of common walk-in counseling clinics have been established through an existing funding relationship between the LHIN and a Family Service Agency

• Walk-in counseling is for individuals who, due to the perceived urgency of the situation, would otherwise consider a visit to the Emergency Department

• Evaluative results from other jurisdictions suggest that about 20% of clients feel they were able to avoid an ED visit as a result of the counseling session

Walk-in single session counseling as an emergency department diversion initiative

• Part-time clinics are available in Deep River & Cornwall

• Part time clinics are available in French and English in Ottawa staggered across every day of the week

• Part time clinics are available in immigrant community agencies in Arabic, Cantonese, Mandarin and Somali

Preliminary results

• The most common presenting problems are depression, anxiety, family breakdown and relationships

• 87% of the clients were satisfied or very satisfied with the service

• 59% reported a decrease in stress

• 15% average decrease in stress between pre and post tests

• “This session moved my life hugely”

• “ A votre intervention effective et non seulement psychologique”

• “Felt like a caterpillar coming in and a butterfly leaving :)”

North Simcoe Muskoka LHINOur geographic area & health service providers

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• 7 Hospitals

• 1 Community Care Access Centres (CCAC)

• 29 Community Support Services (CSS)

• 9 Community Mental Health (MHA)

• 3 Community Health Centres (CHC)

• 26 Long-Term Care Homes (LTCH)

• 465,000 population

• Higher prevalence of chronic conditions than the province

• 17% seniors

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NSM Counselling/Treatment (Walk in)

• Catholic Family Services led the implementation of the two pilots and has expertise in the provision of the service

• Implementation details are based on the evaluation of two Pilot Walk in Clinics (2013)

• weekly in Midland and monthly in Collingwood

• Goal is to have one walk in clinic each day in NSM LHIN at full implementation

• Catholic Family Services Simcoe (CFSS) continues to lead project and provide regional support for Intake and Clinical Supervision at all walk in clinics

• Some investment was needed to enhance Counselling Resources of partners who will provide counselling at the clinics

• Catholic Family Services Simcoe was the agency recommended to receive allocation for Counseling and Treatment $226,000 (2014-15) and $426,000 (2015-16)

Working With Your Local LHIN

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LHINs Mandate: Health System Transformation

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Shared Responsibility for Health System Integration

• Health service providers must identify opportunities to integrate the services of the local health system

• Obligation is individual and collective with the LHIN

• Must engage a “community of diverse persons and entities”

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Working With Your Local LHIN

• Aligning with provincial priorities: “Patients First”

• 2016-2019 Integrated Health Service Plans

• Local advisory tables, steering committees, working groups, etc.

• Presenting solutions: Business cases, return on investment analysis, partnering with others