Hamilton Niagara Haldimand Brant

Local Health Integration NetworkPresentation to the

Norfolk Community Forum on Palliative Care Services

March 5, 2016

Dr. Jennifer Everson,

Physician Lead and Primary Care Physician LHIN Lead, HNHB LHIN

Hamilton Niagara Haldimand Brant

Local Health Integration Network• Created by the Ontario government in

March 2006

• 14 not-for-profit corporations who work with local

health providers and community members to

determine the health service priorities for our

regions

• As Local Health Integration Networks (LHINs),

we plan, integrate, and fund local health services

Data source: IntelliHealth Ontario

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HNHB LHIN Health Service Providers

Community Support Services include CCAC,

mental health and addictions, community

health centres, and other community programs

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Health Service Providers

• Hamilton Niagara Haldimand Brant

(HNHB) Local Health Integration

Network (LHIN) geographic area of

approximately 6,500 km2

• HNHB LHIN is home to

approximately 1.46 million people

(10.5% of Ontario population as of

2015)

• HNHB LHIN allocates

approximately $2.8 billion to

programs and services offered

through Health Service Providers

(HSP)

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Accountability

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A “System” Approach to Health Care

• LHINs provide a structure to

connect health service

providers;

• LHINs are the one structure

which is responsible for the

transition points in health care;

• LHINs ensure that health

service providers not only do

what is right for their own

organization, but what is right

for the system.

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Here’s what some of the 1.46M people we serve

look like• More than 260,000 people 65+ years old in

2015 - projected to be 355,000 by 2025

• Largest growth projected for those > 75 years

• 17% of residents have a first language other

than English or French

• The total registered Indigenous population is

over 28,000 - approximately 50% of whom live

on reserve

• Over 35,000 (2.4% of the population) met the

Inclusive Definition of Francophone

Data sources: IntelliHealth Ontario; 2011 Census, Statistics Canada; Community profiles, Aboriginal Affairs and Northern Development as of February 2015;

2011 National Household Survey, Statistics Canada;)7

Norfolk Population Data• Has the highest rural population in the HNHB LHIN at 55%

• Shares health and social services with Haldimand County

• Adults with mental health and addictions make up the highest users of

Norfolk General Hospital’s Emergency Department

• Unemployment rate: 6.8%

• 5.9% live below the low-income cut-off

• Ranks as the fifth largest agricultural region in Ontario

• Norfolk County is known for tobacco farming

• The self-reported daily smoking rate is 22.2% , slightly higher than the

21.3% reported for the HNHB LHIN, and significantly higher than 18.9%

for all of Ontario. 8

Norfolk Population by Age

0-4

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-74

75+9

2,920

3,140

3,610

4,180

3,610

3,070

2,945

3,220

3,900

4,930

5,370

5,265

4,805

6,710

5,500

Quality Integration Value

Accountable, transparent, and evidence-informed

Strategic Health System Plan

Dramatically Improving the Patient Experience

Primary Care

Home and Community

Care

Health and Wellness of

Our Populations

Engaged communities

Future-Ready

Thinking

What?

How?

Supported

by a focus

on:

That is:

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HNHB Regional Hospice Palliative Care

(HPC) Program Council

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• Established by the LHIN in 2014 - consists of 15-18 members with

representation from various palliative care areas across the HNHB LHIN

geographical area.

• Council’s Mandate

• Act in an advisory capacity to the HNHB LHIN to recommend actions and

activities to strengthen and develop a

and based upon a foundation of involved and supported primary care.

• Provide collaborative leadership to advance standardization, education,

coordination and continuous quality improvement across all sectors within

the HNHB LHIN based on best practices in accordance with the provincial

Declaration Document and aligns with the HNHB LHIN Strategic Plan.

comprehensive integrated regional hospice palliative care program that is

designed around the experience of patients, families

HPC Regional Council Work Plan 2015-18• HPC Regional Council developed a three year work plan with the goal of

advancing an integrated regional HPC program across the LHIN.

• Four priority focus areas of the work plan include:

• Expand access and increase timeliness to a palliative approach to care

• Strengthen hospice palliative care service capacity including care teams

with expertize in HPC in all care settings

• Improve integration of HPC service delivery across all care settings

• Strengthen accountability and introduce shared accountability

across the HNHB LHIN

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HNHB LHIN-Funded Palliative Care Resources

in Norfolk

• Palliative Care Outreach Team (shared with Brant/Haldimand/Six Nations)

• Community Care Access Centre (CCAC) Palliative Care Nurse Practitioner

• Designated End of Life beds: Norfolk General Hospital (three beds)

• Long-Term Care Homes

• CCAC In-home Services: • Nursing

• Personal support

• Occupational therapy

• Speech therapy

• Nutrition

• Physiotherapy

• Social work

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Norfolk Palliative Care Services

• Norfolk General Hospital

• Designated palliative care – End of Life beds (three)

• April – Dec 2015 – 65 individuals admitted to these beds and stayed on average

eight days

• two of the three beds were occupied most of the time (occupancy rate)

• 75% of patients identified as palliative discharged home with in-home supports

between April 1 – September 30 2015

• CCAC In-home services – Between April 1 2015 – January 31 2016

• 159 Norfolk residents received in-home services. These services included:

• Nursing visits 4,885

• Personal support hours 11,189

• Data specific to Norfolk residents not available for the Palliative Care Outreach Teams

and Hankinson Hospice.

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Palliative Care Funding

• The HNHB LHIN supports palliative and end of life patients through funding to

a variety of agencies including:

• HNHB CCAC

• Community Support Service (CSS) providers

• Hospitals

• As of 2015-16 funding for palliative care services in HNHB has increased and

exceeded $40 million. Palliative care funding for in-home care varies based on

the number of patients and their care needs (> $43M in 2014-15).

• Funds are allocated using a robust decision-making framework and look at

factors such as: population health needs, equity, accessibility, alignment with

ministry and LHIN priorities.

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Palliative Care – Moving Forward • Ministry of Health and Long-Term Care’s (ministry)

Patients First - A Roadmap to Strengthen Home and

Community Care – 10 priority areas including Providing

Greater Choice for Palliative and End of Life Care

• HNHB LHIN Integrated Health Services Plan 2016-19

identified palliative care as a priority. Activities align with

the ministry's Roadmap and the Declaration Partnership.

• Key focus areas include:

• Promote early identification

• Improve communication and information sharing

• Increase knowledge on palliative care services and

advanced care planning

• Develop a local palliative care system that provides

patients with greater choice for palliative and end of life

care

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Thank you!

Hamilton Niagara Haldimand Brant

Local Health Integration Network

264 Main Street East

Grimsby, ON L3M 1P8

(905) 945-4930

(866) 363-5446

www.hnhblhin.on.ca

Email: hamiltonniagarahaldimandbrant@lhins.on.ca

@HNHB_LHINgage

www.youtube.com/HNHBLHIN

www.hnhblhin.on.ca

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Questions?

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