the NE LHIN Board of Directors Package

Transcription

NORTH EAST LOCAL HEALTH INTEGRATION NETWORK
BOARD OF DIRECTORS MEETING
Wednesday April 8, 2015
1:30pm-4:30pm
Teleconference
PUBLIC: 877-695-6349 PASSCODE: 9188586
NOTE:
ITEM
DIRECTORS ARE REQUESTED TO NOTIFY THE CHAIR PRIOR TO THE COMMENCEMENT OF
THE BOARD MEETING WITH RESPECT TO POTENTIAL CONFLICTS OF INTEREST ARISING
FROM ITEMS ON THE AGENDA.
TIME
TOPIC
LEAD
PROPOSED
OUTCOME
PAGE #
BOARD OF DIRECTORS MEETING – REGULAR SESSION
1.0
1 min Call to Order: Introductions of attendees
2.0
1 min Declaration of Conflict of Interest
3.0
2 min Approval of Agenda
4.0
1 min Approval of Consent Agenda (If there are no
items requiring removal into regular agenda)
Danielle
Bélanger-Corbin
Danielle
Bélanger-Corbin
Danielle
Bélanger-Corbin
Danielle
Bélanger-Corbin
D
D
CONSENT AGENDA
5.0
Board Attendance
Danielle
Bélanger-Corbin
I
4
6.0
Media Tracker
Louise Paquette
I
5
7.0
Attestation of Compliance
Kate Fyfe
D
10
8.0
Approval of Minutes of Board meeting of
th
January 27 , 2015
Danielle
Bélanger-Corbin
D
14
REGULAR AGENDA
9.0
15 min
Report from the Chair
a) Generative discussion on
Collaborative Governance
b) Board Survey Summary
c) Appointments Directive
Danielle
Bélanger-Corbin
11
20
I
31
10.0
11.0
10 min
I
Report from Audit Committee
• Risk Assessment Report
10 min
• Report on Funding Allocations
12.0
I
Louise Paquette
I
Cynthia Stables
I
• Telehomecare Next Steps
Tamara Shewciw
I
• Orthopedic Plan Results
Martha Auchinleck
I
55
75
Kate Fyfe
D
78
Proceed to closed session to discuss matters
involving: Labour relations
Danielle BélangerCorbin
D
Report from the closed session
D
I
CEO Update
• Funding priorities for fiscal 2015-16
60 min
13.0
20 min
14.0
1 min
20.0
21.0
Engagement Updates (Complaint
Summary, Engagement Tracker,
Northerner’s Survey Responses, IHSP
Development
Financial/Performance Update
• 2015-2016 LHIN Operations Budget
Next Meeting:
• June 10, 2015 Board Meeting
1 min
32
40
Dr. Colin Germond
•
19.0
Rick Cooper
Report from Governance Committee
Adjournment of Board Meeting
D=Decision, I=Information
22
RESOLUTION
NORTH EAST LOCAL HEALTH INTEGRATION NETWORK (the “Corporation”)
Motion No.: 2015-BD00XX
MOVED:
_____________________________________
SECONDED:
_____________________________________
RESOLVED THAT:
The agenda for the Board of Directors meeting of Wednesday April 8 be approved as presented.
_____________________________________
Danielle Bélanger-Corbin
Chair
3
LEGEND
*
Meeting held via teleconference
FF
Director attended meeting in person
TC
Director attended meeting via teleconference
VC
Director attended meeting via videoconference
____
Director was entirely absent from meeting
N/A
No longer a Board Director
2015 BOARD OF DIRECTORS MEETING ATTENDANCE
North East Local Health Integration Network
Members of the Board of Directors
January 27
Sudbury
Danielle Bélanger-Corbin, Board Chair
TC
Dr. Colin Germond
TC
Santina Marasco
TC
Rick Cooper
TC
Dawn Madahbee
TC
Denis Bérubé
TC
Toni Nanne-Little
_____
April 8
Sudbury
June 10
Members of the Board of Directors Audit Committee
February 26
Dr. Colin Germond, Chair
Rick Cooper
Dawn Madahbee
TC
TC
TC
_
Members of the Board of Directors Governance Committee
February 26
Rick Cooper, Chair
Santina Marasco
Denis Bérubé
Toni Nanne-Little
TC
TC
TC
TC
TC
4
September
10
November
26
May 14
October 8
May 14
October 8
Media Tracker and Analysis
January 20, 2015 – March 24, 2015
Key Findings and Analysis
Overall Media:
From January 20, 2015 to March 24, 2015 the North East LHIN was featured in more than 43 news articles,
radio, and TV reports. Large and small media outlets continue to respond to our materials. Reporters often
turn to the LHIN to be a spokesperson on stories they are working on in health care, and often outside of
LHIN work. Several media outlets have now expressed interest in publishing regular health care columns.
According to the Ministry of Health’s most recent media analysis report which measures overall media
exposure for health care in Ontario, the Northern LHIN regions (both NE and NW) had the strongest
“favourable” tone of coverage towards health care system, local coverage.
CEO Blog
Although the blogs generate smaller media interest, they are read by hundreds of Northerners and generate
some of our highest website page views. The blogs continue to provide an intimate and accessible
connection for Northerners to the LHIN CEO. For instance, the latest CEO’s Blog, entitled Florence’s Living
Legacy, was viewed over 400 times and received numerous positive feedback from fellow Northerners.
Below are some of the comments received:
"This is a powerful blog. And this philosophy should be implemented in schools for education plans for
students; in the mental health system, in the justice system – in any system where we want to make a
person’s life better." - Anna
"J’ai lu ton blog avec beaucoup d’intérêt, car il reflète la réalité. Une réalité qui se transforme lentement
mais surement grâce à vos efforts continus. Faut continuer à intégrer, à briser les silos et à encourager les
organisations à travailler ensemble pour le bien-être de tous. Bravo!" – Guylaine
Well done. Merci - Denis
Social Media:
Our social media following continues to grow daily, with our Twitter page exceeding 2,150 followers. Our
Facebook page is also growing but at a much slower rate, with 190 followers. The most popular post this
period was February 9, when we tweeted about the LHIN-funded Virtual Critical Care Unit and its expansion
to seven additional hospitals. On Twitter, the post had nearly 1,700 views, and our Facebook account saw
approximately 565 views. We continue to ensure Tweets and Facebook posts are accompanied by an
interesting photo, allowing for greater pickup and more reach.
5
Website
The website continues to be the largest online medium with the greatest amount of reach for the North East
LHIN. For this time period, the website saw over 21,000 page views, up from 15,000 page views three months
prior. Homepage content is updated several times weekly, and often on a daily basis, to keep the site fresh and
to continue to draw people to the site.
Website statistics, January 20 to March 23, 2015







Sessions: Number of visits to the website.
Users: Number of people visiting the website. Includes both new and returning visitors.
Pageviews: The total number of pages viewed. Repeated views of a single page are counted.
Pages/Session: The average number of pages viewed during a visit to the site.
Avg. Session Duration: The average time on our site is slowly increasing. Our content and promotion
images are becoming more engaging and we are now keeping people on our site longer than before.
Bounce Rate: The percentage of single page visits.
% New Sessions: The percentage of new visits continues to be high, at just more than 33%. We’ve
always realized a fairly high percentage of new visits. This could be attributed to the items we are
sending out as press releases linking back to our website.
Facebook
Our number of followers on Facebook is continuing to grow slowly, as we now have 190 people who ‘Like’ us and
follow our updates. The number of people who talk about, share, or like our posts has remained steady overall.
Our most popular stories on Facebook from January 20 to March 24, 2015 included a post on Virtual Critical Care
and its expansion to seven new hospitals, which received 565 views, and a post on the mental health funding
announcement in March, which saw 316 views.
Number of users who viewed North East LHIN Facebook posts from January 20 to March 24, 2015.
6
Twitter
Our Twitter presence continues to grow, and increases by an average of 15 followers weekly. Our Twitter
page is viewed an average of over 1,000 times per week, and we continue to post photos, media
releases, and retweets relating to health care in the Northeast. This has allowed the NE LHIN twitter
page to grow to over 2,150 followers. We continue to post in both English and French and interact with
our followers. Releases that are posted to our Twitter feed drive hits to our website, which strengthens
our overall media reach in the North East. Our most popular tweet for
Date
Followers
March 2015
2150
this period was the Virtual Critical Care announcement which
February 2015
2106
received over 1,700 views on Twitter alone.
January 2015
December 2014
November 2014
October 2014
September 2014
August 2014
July 2014
June 2014
May 2014
April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
Feb 2013
January 2013
December 2012
2065
2025
2001
1978
1953
1920
1890
1844
1792
1757
1711
1668
1610
1598
1569
1513
1455
1425
1346
1291
1234
1135
1041
990
Followers
2500
2000
1500
1000
500
0
Earned Media
1. Funding Announcement: North East LHIN Invests in Home and Community Care for Seniors in
Espanola (Jan 22). Facebook hits: 33; Twitter hits: 430; Media pick-up: Mid North Monitor.
2. Sharing Quality Improvement Ideas to Benefit Northern Patient Care (Jan 22). Facebook hits: 37;
Twitter hits: 367, Media pick-up: Moose FM Timmins.
3. New Year or Old Year – It’s Still Diabetes to Me (Jan 27). Facebook hits: 34; Twitter hits: 824; Media
pick-up: Bay Today.
4. Sudbury-made post stroke program expands to new cities - Northern Life (Jan 27).
5. First Nations Community Support Services Summit (Jan 30). Facebook hits: 27; Twitter hits: 697;
Media pick-up: MooseFM Timmins.
6. Virtual Critical Care Expands To Seven New Hospitals: Article submitted to Canadian Health Care
Technology magazine – Dr. Manchuk was interviewed for future publication (Feb 3).
7
7. Local LHIN reacts to recent survey on senior health care – Timmins 99.3 radio (Feb 3).
8. KDH and EDH moving forward to hire CEO – Northern News (Feb 6).
9. Health centre-led initiatives will benefit patient care across Manitoulin Island – Manitoulin Expositor
(Feb 9).
10. Virtual Critical Care Expands To Seven New Hospitals (Feb 9). Facebook hits: 565; Twitter
hits:1,652; Media pick-up: CBC, Northern Life.
11. North East LHIN Salutes -- Making House Calls to Seniors in Espanola and Connecting them to Care
(Feb 11). Facebook hits: 22; Twitter hits: 534; Media pick-up: CBC; Sudbury Star.
12. Funding Announcement: North East LHIN Helping Seniors in North Bay and Mattawa Get Care in
Community (Feb 13). Facebook hits: 58; Twitter hits: 689; Media pick-up: North Bay Nugget,
BayToday, CKAT radio North Bay, Cogeco TV and CTV.
13. Another Physician Leader Starts Work with the North East LHIN (Feb 17). Facebook hits: 28; Twitter
hits: 362; Media pick-up: Timmins Daily Press.
14. Shadows of the Mind Film Festival - North East LHIN Sponsors Ernest and Celestine (Feb 18).
Facebook hits: 35; Twitter hits: 467; Media pick-up: Sault Star.
15. North East LHIN continues to support medical team trips for care for seniors living in coastal
communities (Feb 23). Facebook hits: 148; Twitter hits: 374; Media pick-up: CBC radio, MooseFM
Timmins, Tweet by Dr. Eric Hoskins, Timmins Daily Press.
16. Home care top issue in online survey: LHIN - Northern Life and BayToday (Feb 24).
17. Fentanyl Patch 4 Patch exchange program announced - Local2Sault Ste. Marie (Feb 24).
18. North East LHIN - Patient Experience Survey - Wawa-News (Feb 25).
19. Sudbury Physician Takes on Leadership Role at the North East LHIN (Feb 26). Facebook hits: 62;
Twitter hits: 608; Media pick-up: Northern Life, Sudbury Star.
20. North East Local Health Integration Network (NE LHIN) Welcomes New Senior Director (Feb 27).
Media pick-up: Northern Life, Sudbury Star.
21. North East LHIN Speaks to Importance of Northern Voices and Partnerships in Strengthening
Northeastern Ontario’s Health Care System (March 2). Facebook hits: 37; Twitter hits: 432; Media
pick-up: WawaNews.
22. Louise's March Blog - Florence’s Living Legacy (March 4). Facebook hits: 43; Twitter hits: 389; Media
pick-up: WawaNews.
23. Funding Announcement in North Bay: North East LHIN Invests in Meeting the Needs of People
Experiencing Mental Health and Addictions Issues (March 11). Facebook hits: 316; Twitter hits: 541;
Media pick-up: BayToday, North Bay Nugget, CTV, Cogeco, CKAT North Bay, WawaNews, Northern
Ontario Medical Journal.
8
24. Ontario government invests in mental health and addictions - Manitoulin Expositor (March 11).
25. New Board Director from Sault Ste. Marie Joins North East LHIN Board of Directors (March 12).
Facebook hits: 55; Twitter hits: 277; Media pick-up: Sault Star, West Parry Sound Health Centre
newsletter.
26. Small, Medium and Large Northeastern Hospitals Collaborate to Improve Pharmacy Services (March
16) Facebook hits: 128; Twitter hits: 247; Media pick-up: Interview with Radio-Canada, Parry Sound
MooseFM, North Bay 600 CKAT, CJKL Kirkland radio.
27. Northern Ontario Medical Journal (March 2015): Review sets out roles of hub and feeder hospitals,
NE LHIN helping seniors in North Bay and Mattawa, North Bay Mobile Crisis Team pairs police,
nurses, PATH program helps patients with hospital-to-home transitions, Primary care memory clinics
speed assessments.
28. Northerners Share Strong Opinions about Home and Community Care (March 24) ) Facebook hits:
50; Twitter hits:209; Media pick-up: Wawa-News, CJKL Kirkland radio, live interview on CBC radio.
Marketing/Advertising
Northern Ontario Medical Journal Ad - Spring 2015 Issue
9
555 Oak Street East, 3rd Floor
North Bay, ON P1B 8E3
Tel: 705 840-2872
Toll Free: 1 866 906-5446
Fax: 705 840-0142
www.nelhin.on.ca
555, rue Oak Est, 3e étage
North Bay, ON P1B 8E3
Téléphone : 705 840-2872
Sans frais : 1 866 906-5446
Télécopieur : 705 840-0142
www.rlissne.on.ca
ATTESTATION
Prepared in accordance with section 14 of the
Broader Public Sector Accountability Act, 2010 (BPSAA)
TO:
The Board of Directors of the North East LHIN, (the “Board”)
FROM:
Louise Paquette
Chief Executive Officer
North East LHIN
Date:
April 8, 2015
RE:
January 1, 2015 to March 31, 2015 (“the Applicable Period”)
On behalf of the North East 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 section 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.
…/2
10
-2In 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.
Dated at Sudbury, Ontario this April 8, 2015:
Louise Paquette
Chief Executive Officer
North East LHIN
I certify that this attestation has been approved by the board of the North East LHIN on April
8, 2015.
Chair, Board of Directors
North East LHIN
11
SCHEDULE A to Attestation
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
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;
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 – to
be added once ss. 14(1)(c.1) of the Act is proclaimed into force)
If the LHIN has exceptions to declare under 1-5, please:
•
•
•
list them accordingly;
provide a rationale for each exception in respect of why the LHIN did not comply; and
describe what actions have been, or will be taken, to address each exception.
Please note that if any exceptions declared in a previous declaration of compliance made by
the Board on behalf of the LHIN continue through this reporting period, they must also be
declared in Schedule A of this declaration.
If you are in doubt as to how to complete this Schedule, please contact your legal counsel.
Please delete this note before completing Schedule A.
12
SCHEDULE A
to
Attestation For
North East LHIN
For the Applicable Period: January 1 to March 31, 2015
1.
2.
MEMORANDUM OF UNDERSTANDING; AND
MINISTRY LHIN ACCOUNTABILITY AGREEMENT/MINISTRY LHIN PERFORMANCE AGREEMENT
Possible Non-Compliance.
The NE 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 NE LHIN is endeavoring to
resolve this accidental breach by seeking approvals required by LHSIA, the Financial
Administration Act, the MOU and the MLPA. Toronto Central LHIN, on behalf of all
LHINs, continues to work on a submission to the Ministry of Health and Long-Term Care
and the Ministry of Finance.
3.
COMPLETION AND ACCURACY OF REPORTS REQUIRED PURSUANT TO SECTION 5 OF THE
BPSAA
NO KNOWN EXCEPTIONS
4.
PROHIBITION ON ENGAGING LOBBYIST SERVICES USING PUBLIC FUNDS PURSUANT TO SECTION
4 OF THE BPSAA
NO KNOWN EXCEPTIONS
5.
COMPLIANCE W ITH APPLICABLE DIRECTIVES ISSUED BY MANAGEMENT BOARD OF CABINET
a. OPS PROCUREMENT DIRECTIVE
NO KNOWN EXCEPTIONS
b. OPS TRAVEL, MEAL AND HOSPITALITY EXPENSES DIRECTIVE
NO KNOWN EXCEPTIONS
c. [TO BE ADDED ONCE SS. 14(1)(C.1) IS PROCLAIMED INTO FORCE] OPS PERQUISITES
DIRECTIVE
NO KNOWN EXCEPTIONS
13
MINUTES OF PROCEEDINGS
NORTH EAST LOCAL HEALTH INTEGRATION NETWORK
BOARD OF DIRECTORS MEETING
January 27, 2015
9:00am
Teleconference
PARTICIPANTS:
Santina Marasco
Dawn Madahbee
Dr. Colin Germond
Denis Bérubé
Louise Paquette
Cynthia Stables
Tamara Shewciw
Kate Fyfe
Terry Tilleczek
Martha Auchinleck
REGRETS:
Rick Cooper
SCRIBE:
Micheline Beaudry
AGENDA ITEM
DISCUSSION
ITEM 1.0
Call to order: Introductions of attendees
Chair Danielle Bélanger-Corbin called the meeting to order
at 9:04 am.
Declaration of Conflict of Interest
No conflicts of interest declared.
ITEM 2.0
ITEM 3.0
Approval of Agenda
Added to agenda – Item 9d – MLPA motion
{MOTION 2015-BD0094}
That the agenda for the Board of Directors meeting of
th
Tuesday, January 27 , 2015 be approved with addition of
Item 9D.
MOVED: Colin Germond / SECONDED: Dawn Madahbee
{CARRIED}
ITEM 4.0
Approval of Consent Agenda
Includes the following items:
5.0 Board Attendance
6.0 Media Tracker
7.0 Attestation of Compliance
8.0 Approval of Minutes of past Board meeting of
December 8th and 17th, 2014
Page 1
14
ACTION
RESPONSIBLE
The consent agenda for the Board of Directors meeting of
Tuesday, January 27th be approved as presented including:
- Board Attendance
- Media Tracker
- Attestation of Compliance
- Approval of Minutes of past Board meeting of December
8th and 17th
MOVED: Santina Marasco / SECONDED: Denis Bérubé
{CARRIED}
ITEM 9.0
Report from the Chair
a) Update from LHIN leadership meeting on January 22nd,
2015 – Danielle Bélanger-Corbin reported that both Dr.
Bob Bell and Dr. Hoskins participated in the meeting of
January 22nd 2015 and highlights include :
 OMA negotiations between government and OMA
 Home and Community Care – upcoming “Donner”
report
 Action Plan 2.0 (February 2, 2015)


The Auditor General is looking at governance within
LHINs. More information will be available in the next
couple of months. The scope of the audit has not yet
been decided; still at preliminary stage. Audit
information will be forwarded to board members when
it’s received.
Sub Committee Strategic Direction 3.0 is being
developed.
Danielle reported that she and Kirsten Farago, NE LHIN
Long-Term Care Lead, met with Associate Minister of
Health and Long-Term Care, Dipika Damerla regarding the
challenges that we Northeastern Ontario faces regarding
long-term care. The Ministry has 3000 LTC beds that will
be re-developed. In the NE LHIN, 19 of the 40 LTC homes
are eligible for this redevelopment.
b) NE LHIN Board Appointment Update – Danielle
reported that one candidate is awaiting approval from the
Order in Council. Four applications have been received
and will be reviewed at the Governance committee on
February 26th. Two openings are remaining to be on the
Board.
c) Appointment of Vice Chair – Appointment of a ViceChair requires the approval of the Order in Council.
Page 2
15
A briefing note will
be provided to the
board on the status
of LTC homes redevelopment.
Kirsten
Farago
The NE LHIN Board of Directors recommend that to the
Public Appointments Secretariat and the Minister that Mr.
Rick Cooper be appointed as Vice-Chair of the Board.
MOVED: Denis Bérubé / SECONDED: Colin Germond
{CARRIED}
Committee Memberships:
Governance – Rick Cooper (Chair), Santina Marasco and
Denis Bérubé. The new member appointed to the Board
will also be asked to sit on Governance. Danielle BélangerCorbin will remain on committee as ex-officio.
Audit – Dr. Colin Germond (Chair), Rick Cooper and Dawn
Madahbee. Danielle Bélanger-Corbin will remain on
committee as ex-officio.
Dr. Colin Gemond has agreed to sit on the Health
Professional Advisory Committee.
Dawn Madahbee has agree to sit on the Local Aboriginal
Health Committee.
New board members have been mandated for a one day
governance session. Denis Bérubé and Danielle BélangerCorbin will be attending the French session in the Spring.
Date has yet to be determined. Dawn Madahbee will
participate at English session.
d) MLPA Motion
It has been requested that the LHIN Leadership Council
and Chair Council act on behalf of the LHIN to coordinate
and manage the negotiation process for the renewal of the
LHIN-Ministry Performance Agreement for 2015-16. A
document with details of the process and principles for the
Provincial LHIN Negotiating Committee has been provided
to the board members.
The North East LHIN Board of Directors hereby authorizes
the LHIN Leadership Council, through a small Work Group
with representation from LHIN CEOs and Board Chairs, to
act on behalf of the LHIN to coordinate and manage the
negotiation process for the renewal of the LHIN-Ministry
Performance Agreement for 2015/16.
MOVED: Dawn Madahbee / SECONDED: Colin Germond
{CARRIED}
Page 3
16
New members to
attend governance
session.
Denis Bérubé
Dawn
Madahbee
ITEM 10.0
Financial/Performance Update
a) Operations Update
Kate Fyfe provided presented the third quarter operations
report.
Be it resolves that the board accepts the report as
presented.
MOVED: Colin Germond / SECONDED: Denis Bérubé
{CARRIED}
ITEM 11.0
Integration:
Martha Auchinleck reported that the Englehart and
District Hospital and Kirkland and District Hospital
submitted a notice of intent to integrate.
WHEREAS the Englehart and District Hospital and the
Kirkland and District Hospital intend to enter into a
voluntary, horizontal integration in the form of a
partnership agreement at the executive and management
levels;
AND WHEREAS, through the partnership, the hospitals will
jointly manage the health services that are currently
provided, while planning together for the future, with the
hiring of a single Chief Executive Officer for both
organizations;
AND WHEREAS, through the partnership, the hospitals will
develop one mission, one vision and one set of values, and
will create a strategic plan to propel them towards their
shared vision;
THEREFORE BE IT RESOLVED THAT, upon the NE LHIN’s
review of both organizations’ notice of intended
integration under Section 27 of the LHSIA, the Board of
Directors of the NE LHIN will not stop the request for a
Shared Leadership and Planning integration between the
Englehart and District Hospital and the Kirkland and
District Hospital.
MOVED: Santina Marasco / SECONDED: Colin Germond
{CARRIED}
ITEM 12.0
Proceed to Closed session to discuss matters involving:
Labour relations Matters prescribed by regulation
{MOTION 2015-BD00100}
Page 4
17
Variance column to
be added to
operations forecast
summary graph.
Kate Fyfe
“The members attending this meeting move into a Closed
Session pursuant to the following exceptions of LHINS set
out in s.9(5) of the Local Health Integration Act, 2006.”
☒ Labour relations
BE IT FURTHER RESOLVED THAT; the following persons be
permitted to attend:
For the discussion regarding Matters prescribed by
regulations:
Louise Paquette, CEO
Kate Fyfe, Senior Director
Martha Auchinleck, Senior Director
Terry Tilleczek, Senior Director
Cynthia Stables, Director
Tamara Shewciw, Chief Information Officer
Micheline Beaudry, Executive Assistant to the CEO and
Board Liaison
MOVED: Rick Cooper / SECONDED: Colin Germond
ITEM 17.0
{CARRIED}
Report from the Closed session
{MOTION 2015-BD00101}
The Board of Directors of the NE LHIN received the report
of its Closed Session meeting of January 27th, 2015.
MOVED: Denis Bérubé / SECONDED: Santina Marasco
ITEM 18.0
ITEM 19.0
{CARRIED}
Next Meetings
 February 26, 2015 (Audit and Governance)
 April 8, 2015 (Board)
Adjournment of Board Meeting
{MOTION 2015-BD00102}
The North East LHIN Board of Directors meeting of January
27th, 2015 be adjourned at 10:42 am.
MOVED: Rick Cooper/ SECONDED: Colin Germond
{CARRIED}
AGENDA DEVELOPMENT
FOR NEXT MEETING
__________________________
Chair
__________________________
Colin Germond
Director
Page 5
18
RESOLUTION
MOVED:
_____________________________________
SECONDED:
_____________________________________
April 8, 2015
RESOLVED THAT:
The consent agenda for the Board of Directors meeting of April 8 be approved as presented including:
- Board Attendance
- Media Tracker
- Attestation of Compliance
- Approval of Minutes of Board meetings of January 27, 2015
_____________________________________
Chair
19
Purpose:
To summarize individual LHIN discussions on collaborative governance and results
of the participant evaluation, and to recommend next steps.
To:
LHIN Leadership Council
From:
Collaborative Governance Work Group
Date:
January 9, 2014
Meeting Date: January 22, 2015
Action:
For decision
KEY RECOMMENDATIONS:
1. That LHIN Board Chairs distribute this document to their Boards, including the summary of
individual LHIN discussions, and have a generative discussion at a future Board meeting. A
brief summary of the Board’s discussion will be submitted to the Work Group to guide
planning of further work.
2. That the Work Group conduct a survey of LHINs to gather LHIN experiences with collaborative
governance and to determine whether there is collective interest in holding a second panLHIN education session to discuss these experiences and case studies.
3. That the Leadership Council bring back as a priority for 2015/16 to improve our use of
technology for pan-LHIN Board education and collaboration (this was identified about 2 years
ago as an area for collective work) or consider an annual face-to-face education session for
LHIN Boards.
BACKGROUND/CONTEXT
The pan-LHIN board education session on collaborative governance was held on November 27,
2014. This report provides a brief summary of the individual LHIN discussions of collaborative
governance held immediately following the pan-LHIN session, and the results of a participant
evaluation of the session conducted in December 2014. More detailed summaries of the LHIN
discussions and the survey results are available from the Collaborative Governance Work Group.
LHIN DISCUSSIONS OF COLLABORATIVE GOVERNANCE
Common themes from LHIN discussions following the pan-LHIN education session include:
FINAL – January 15, 2015
1|P a g e
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
Integration is more than mergers; there is a full spectrum of collaboration options of which
merger is only one. LHIN and our HSP efforts need to address the full range of integration
possibilities.

Integration itself is not the goal, rather it is a means to achieve the real goal of improved patient
care and patient outcomes. The focus should be on “integrated care” not “integration”.

We can do more to educate HSP Boards that acting in the “best interests” of their organization
includes an obligation under LHSIA to seek opportunities for health system integration. LHINs
should work together to communicate this message consistently across all LHINs.

Much more can be learned from individual LHIN experience with collaborative governance and
local health system integration. Future collective efforts should focus on sharing case studies
and best practices from the experience of each LHIN.
EDUCATION SESSION EVALUATION
Key themes from the participant evaluation survey of the pan-LHIN education session include:

Very positive feedback about the individual LHIN discussions following the education session.
Some noted the benefit of having HSPs present for, or participating in, the LHIN discussion.

For many, the pan-LHIN session supported the objective of providing continuous education for
LHIN Boards and the advance material was useful to prepare for the meeting. Some suggested
better communications about the session objective and why it was held at that time.

Many found the refresher on LHSIA and integration obligations useful, while some felt it
provided no new information for experienced Board members in particular.

The presentations received very positive feedback. Greater use of individual LHIN examples and
case studies was suggested for future sessions.

While technology is a good way to conduct pan-LHIN education, many felt a more interactive
platform is needed to allow real-time questions and dialogue. More training and experience
with the existing technology was suggested also so sessions run more smoothly.

HSP participation in LHIN Board education sessions should be clarified and materials made
available in French and English. Content should focus on and engage all health sectors equally.

The LHINs need to develop and communicate a shared understanding of collaborative
governance including what it is, what it means to LHINs, and how it relates to our collective goal
of a patient-centered health system.
LESSONS LEARNED
The Collaborative Governance Work Group identifies the following lessons learned from its
experience planning the education session and the feedback received from participants:
2|P a g e
21

There is an overarching shared interest in strengthening the LHIN capacity for local integration
that aligns with an overall provincial integrated health system.

There is a shared interest in providing information and education to HSPs on collaborative
governance and supporting the capacity-building of HSPs for local integration leadership and
management. This includes communicating to HSPs in a clear and consistent manner about
their role in integration and their obligations to seek integration opportunities.

There is support for further pan-LHIN Board education on topics of shared interest. Given the
unique approaches, priorities and perspectives of LHINs, all education topics are not suited to a
collective effort. Those topics best suited to pan-LHIN Board education are either new to all
LHINs, so there is a common interest in establishing the same base of knowledge, or are topics
in which all LHINs have experience, so there is a collective benefit in sharing experiences and
best practices.

Further work is needed to improve the use of available technologies, such as OTN, so that panLHIN sessions are more interactive, accessible from multiple locations and run smoothly.

There was agreement over a year ago to use technology to support collective LHIN Board
education, but this was not included in the Leadership Council priorities for the current year.
Further attention should be put towards maximizing the use of available technologies and a
discussion held about whether to hold an annual face-to-face session for LHIN Board members.

The objectives, planning parameters and expected outcomes of a pan-LHIN initiative need to be
approved in advance by the Leadership Council to ensure that a Work Group has clear direction
and all LHINs have the same understanding of how it will unfold. Last minute changes need to
be discussed and approved by the Leadership Council.
NEXT STEPS
The feedback received from LHIN Boards and individual participants in the pan-LHIN education
session indicates a collective interest in doing more to share experiences and learnings amongst
LHINs and to provide information and education for HSPs.
RECOMMENDATIONS
The Collaborative Governance Work Group makes the following recommendations to the LHIN
Leadership Council:
1. That LHIN Board Chairs distribute this document to their Boards, including the summary of
individual LHIN discussions, and have a generative discussion at a future Board meeting. A brief
summary of the Board’s discussion will be submitted to the Work Group to guide planning of
further work.
3|P a g e
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2. That the Work Group conduct a survey of LHINs to gather LHIN experiences with collaborative
governance and to determine whether there is collective interest in holding a second pan-LHIN
education session to discuss these experiences and case studies.
3. That the Leadership Council bring back as a priority for 2015/16 to improve our use of
technology for pan-LHIN Board education and collaboration (this was identified about 2 years
ago as an area for collective work) or consider an annual face-to-face education session for LHIN
Boards.
ATTACHMENT:
Appendix A: Summary of LHIN Discussions on Collaborative Governance
4|P a g e
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Summary of LHIN Discussions on Collaborative
Governance
After the pan-LHIN education session, each LHIN Board discussed three questions asking LHINs to reflect
on the session and their own experience with collaborative governance and integration. The following is
a summary of the individual LHIN discussion notes submitted to the Collaborative Governance Work
Group.
Question 1: What is your most important takeaway about the opportunities of
collaborative governance from the session today?
INTEGRATION IS MORE THAN MERGERS

It reinforced that there are many ways to develop a more integrated and coordinated system
before considering full merger. Integration is only one of many options along a continuum of
options.

It reinforced that integration is only one of the tools LHINs have to build a better health care
system and better outcomes for the patient. Integration is not an end in itself.

Anne Corbett’s “Ten Tips for Successful Integration” was very helpful as was the scaling of
integration she spoke about – voluntary to amalgamation.

The review of the definition of “integration” was helpful.

There are many different opportunities and ways in which HSPs can work together, long before
full integration is the answer – it doesn’t have to be all or nothing. Most HSPs assume that
integration means only full merger and dissolution but there are less drastic steps that yield
positive results.
BETTER PATIENT CARE AND OUTCOMES IS THE GOAL

An integrated system is not the goal, better patient care and patient outcomes are.

Integration means HSP boards working collaboratively by sector, across sectors, and across
borders and taking decisions that will affect and change the health system in a positive manner.
It also means being more efficient with our resources and finding better ways to serve the
population of our LHIN. To focus on a patient’s needs through the continuum of care and ensure
better transitions in care.

The “driver” for any further collaborative governance work amongst LHINs and with HSPs should
be to collectively improve the patient (caregiver/family) experience.

It is important to remember that LHINs have the authority to restrict funding however HSPs do
not have the authority to restrict services – this is a fine line. Integrations must be in the best
interests of the people and patients and must not impact service delivery in a negative way.
5|P a g e
24

If we are working towards system integration it needs to be the focus. The idea of integration
may be a distraction. The interests of the patient need to be a focus all the time instead of what
HSPs can and cannot provide.
“BEST INTERESTS” INCLUDES SEEKING INTEGRATION OPPORTUNITIES

The clarity that an HSP Board’s responsibility to support system integration and identify
integration opportunities falls within its duty “to act in the best interests” of its own
organization. It is clear that HSP Boards need to see through a system lens not only their own
organizational lens. LHINs need to educate HSP Boards about this role.

The Board noted that they were not aware that every health service provider is obliged to seek
integration opportunities in the health care system.

Other influences such as budget pressures and Health Links create integration opportunities
that should be leveraged to develop more integrated care for patients.

There is a need to raise awareness amongst HSPs about their role in identifying opportunities for
integration. Perhaps it could be listed as an accountability in the service accountability
agreements.

The challenge is putting collaborative governance theory into practice with HSPs who view their
long-standing structure as essential. The fear of change is real with all providers, especially
smaller ones.
VALUE OF LEARNING FROM EACH LHIN’S EXPERIENCE





It was valuable to hear some of what other LHINs are doing. It would be helpful to develop
better mechanisms to continue to share experiences with each other.
The session reinforced we are on the right track in the work we are doing in our LHIN.
Focus future sessions on understanding each LHIN’s knowledge and practices.
Our LHIN’s current level of governor-to-governor engagement is quite strong, specifically
between HSP and LHIN governors. An example is our Governance Advisory Councils which meet
at least three times a year.
The LHINs would benefit from more collaborative work with each other to get a window on the
complexity of working together.
OPPORTUNITIES FOR FURTHER PAN-LHIN ACTIVITY

Offer a similar session or recorded session for orientation of LHIN Board members.

A more interactive session is suggested using case studies or scenarios where LHIN Board
members could work through situations. Include a case study on a failed integration and the
lessons learned.
6|P a g e
25

Look at how other ministries are achieving cross-organizational coordination in governance
processes, for example the work on accessibility currently underway by the Ministry of Child and
Youth Services.

There is merit in awaiting the results of the recent LHSIA review which may identify possible
opportunities for the LHINs to implement collectively.

The Ministry’s support of LHINs’ authority and integration efforts needs to be clear. The Ministry
needs to support the LHINs’ authority when it comes to integration.

Use Health Links to enhance and compel collaborative governance.
Question 2: What new ideas or learnings could you consider or incorporate into
efforts to further advance integration in your LHIN?

The role of HSP governors in supporting increased integration, and in supporting it as a priority
for their CEO/Executive Director, and as an important element of the transformation agenda.

Each LHIN faces different challenges because the capacity of HSPs to undertake integration
varies widely by organization. Some rely on the LHIN to provide direct assistance and support.

It is the LHIN’s responsibility to formally educate HSP Boards (and the HSP Boards’ public) about
the range of collaborative opportunities and their obligation to look for integration (broadly
defined) opportunities. Further Board to Board sessions are helpful in developing this
understanding. With HSP Board understanding and support, more successful integrations can
take place, improving the health care system for patients.

We will continue to collaborate with our HSP Boards focused on supporting and accelerating the
outcomes of our Integrated Health Services Plan (IHSP).

Implement a campaign to better educate our HSPs on integration and their responsibilities and
obligations regarding integration.

The Board discussed whether we are providing an appropriate level of governance support for
these agencies. The Board agreed to discuss this with the agencies at our next Board to Board
meetings with the sectors.

Ask Anne Corbett if we can send the article Integration Transactions: The Role of the Board and
possibly her slides to HSP Boards and ask them to table for discussion at their next Board
meeting, in anticipation of a future Governance to Governance session or a regular education
session.

Focus integration and coordination efforts and communications around the needs of the
patient.

Our Board would be interested in evaluating the current governance engagement strategies that
we use in our integration work. We have modeled them around best practices and feedback
from providers and chose to engage the Chairs of HSPs early in the process.
7|P a g e
26

Acting on our legislative authority and taking the bold steps needed to continue to include
integration in our local transformation agenda.

LHINs must have the support of the Ministry and Minister in enacting our legislative authority.

Integrations can be very challenging to carry through and communities need assistance and
education to support them – this is a very resource intensive exercise for the small compliment
of staff at most LHINs.

Shift the emphasis from “integration” to “integrated care.”
Question 3: Provincially, Collaborative Governance has been identified as a topic
for collective work by the LHINs this year. What would you like this
collective effort to focus on?
SHARE INFORMATION AND LEARNINGS AMONGST LHINs

Provide a forum to share each LHIN’s experience, practices and learnings about collaborative
governance and system change.

Provide educational resources but recognize regional differences and let individual LHINs lead
when it comes to establishing what is to be done within their own regions.

The Collaborative Governance Work Group should focus on sharing successes and case studies
with insight into how the integration was planned and completed and the difference it made to
patients.

Understanding what is working in other LHINs, particularly what strategies and approaches work
when there is push back.

We would be interested in further exploring ideas of collaboration across LHIN governors, this
could include future sessions where we hear from some of the other Boards on integration best
practices.

We would like to have a better understanding of what other LHINs are doing and what they feel
are the strengths of their governance structures.

We appreciate the information shared by NSM LHIN and would be interested in hearing if there
are aspects of the model that would be changed. Also, would like to know whether this model
has resulted in better patient outcomes and learn more about the “Governance Coordinating
Council.”

Developing best practices and messages for supporting integration.

Compile success stories, challenges and obstacles from the experience across the LHINs. An
example in our LHIN would be the recent mental health and addictions amalgamation best
practices and lessons learned.

There is interest in creating a central clearing house for this type of information for all system
partners. The governance portal is a good example but it has not been maintained.
8|P a g e
27

Understanding the best practices for various types of situations / circumstances, with an
emphasis on being able to articulate the tangible and measurable outcomes.

Defining common metrics to assess the system impacts of amalgamations. While each
amalgamation would be unique, there may be common elements, such as cost savings and
improved patient experience, which would be relevant in all amalgamations. Benefits of
defining common metrics would be enhanced ability to compare the impact and outcomes of
amalgamations (e.g., one large scale hospital amalgamation versus another one) and consistent
interpretation of metrics.
CLARIFY PAN-LHIN, LHIN, HSP ROLES

Clarifying the role of collaborative governance at the provincial pan-LHIN level and individual
LHIN level.

Developing a white paper on collaborative governance that defines the concept within the
health care sector might be a worthwhile project. It could provide consistent messaging from
the LHINs. Each LHIN would supplement the core document with specific examples of success
from within their LHIN and use it as an educational/information piece.

We often focus on integration of HSPs but could focus more on integration at a system level (i.e.
at Board level having a super Board to formally integrate ideas and communication). Other
strategies for promoting communication at a Board level could also be a focus.
PROVIDE INFORMATION, EDUCATION AND SUPPORT TO HSPs

Educating HSPs is pivotal and we spend a lot of time educating the public, through ongoing
engagement and communication efforts, about the need for a more coordinated local system.

It is helpful for HSPs to hear what other HSPs are doing in other parts of the province with
respect to integration, quality improvement and the patient/client experience. Knowing that
others are taking a similar approach both encourages and supports momentum locally.

Continue to communicate the expectation that HSP governors need to play a role in the
oversight of their own organizations within the broader context of the health system. This
includes teleconferences, education by associations (e.g., OHA) and local LHIN governance to
governance work.

Have Anne Corbett conduct 2 or 3 further, in-depth sessions that HSPs could participate in such
as a regional presentation.

Develop a set of guidelines for HSP Boards to use to pursue integration at a governance level.

HSPs in our LHIN would benefit from a workshop on this topic. This could include a session for
individual sectors to support our work to commence a LTC plan and a CSS plan.
9|P a g e
28

HSP Boards need access to tools developed in our LHIN to help with their collaborative
governance and application. Tools available on our website include a Board-to-Board
Collaborative Governance Toolkit (Champlain LHIN)

HSP Boards need to learn a lot – first their fiduciary duties and about the health system in
general, then look at the bigger picture. Boards that are mature can focus more on their role in
system improvement.

More education is needed for HSP Boards related to collaborative governance – we must define
integration, what it looks like for HSPs and the results that LHINs expect.

The changes needed must start at the grassroots level – it has to come from the community in
order to get the buy-in and momentum needed to make it happen. LHINs are doing all they can
on engagement and communication. Policy setting and support from the Ministry and Minister
need to be there also to complement the work of the LHINs.

Hold sessions on a regional basis.

Have a document that captures the whole picture.

LHINs must get HSPs working on integration. Consider who the integration champions are and
how they could collaborate and speak with others about their success.

About 50% of governors at a recent governance course indicated that the resources aren’t
sufficient for what is required. We have resources to govern our own boards but not beyond
that. We need to support Boards and think of different strategies and opportunities based on
the state of each HSP Board.

Develop a framework for communications around change management (similar to the
framework for community engagement). Given the different sizes of organizations involved in
amalgamations, it may make sense to have the framework customized to size of organizations –
large versus small to medium. It is likely that we will see more amalgamations in the future; the
communications framework would provide organizations with a starting template covering to
whom, how and when to communicate changes. Benefits would be increased efficiency (the
entities would not have to “start from scratch”), opportunities for smaller scale amalgamations
to learn from larger amalgamations and vice versa, and improved stakeholder relations as the
change communications framework would help ensure key constituencies are covered and the
impact monitored.

Focus on best practice for integration, lessons learned from integrations and any kits or
documents that could be used, especially by smaller organizations that need support.
OTHER FEEDBACK

LHIN Leadership Council needs to start having discussions with OHA, what integration means
and what it means to govern it.

Pan-LHIN Board education sessions need to be more frequent. They are good mechanisms to
talk about topics with all Boards present.
10 | P a g e
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
The session seemed very hospital centric. More focus on collaborative governance theory would
be helpful.

The overall objective of the session was not clear and not sure there was a collective
understanding of “collaborative governance” following the session.

A suggestion was made during our discussion related to the Deputy Minister’s presentation – for
us to build a blueprint of what the future health system is supposed to look like and establish a
common strategic vision for the Boards of what the system needs to look like (i.e., role of the
hospitals, big and small).
11 | P a g e
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Ministry of the
Attorney General
Ministère du
Procureur général
Legal Services Branch
Direction des services juridiques
Local Health Integration
Networks
Les réseau locaux
d’intégration des services de
santé
425 Bloor Street East, Ste 501,
Toronto, Ontario, M4W 3R4
425, rue Bloor Est, Bureau 501,
Toronto (Ontario), M4W 3R4
Direct Line: (416) 969.3593
E-mail:
[email protected]
The New Agencies & Appointees Directive
On February 2, 2015 the government’s new Agencies & Appointees Directive came into
force. This new directive consolidates the Agency Establishment & Accountability
Directive with the Government Appointee Directive. LHINs are now classified as “boardgoverned provincial agencies.”
Highlights for the LHINs
The new Directive applies to the LHIN and sets out a framework for governance,
accountability, appointments and remuneration.

New:
o Risk reporting: Ministries are to report on agency risks quarterly and that
requirement is likely to filter down to the LHINs, who currently report
annually.
o Mandate Reviews: agency mandate reviews are required every seven
years (s. 39 of LHSIA has a review provision and last year there was
Standing Committee work); and,
o MOU Reviews: MOUs are deemed to have their termination dates
removed, with a review required upon a change of a Chair or a Minister; the
LHIN MOU expires in 2017 and has such a provision already, which the
Ministry declined to use when Minister Hoskins was appointed.

Not New for the LHINs: there are requirements that may be new for other
agencies, but not the LHINs, for example: annual Chair and CEO attestations of
compliance for laws and directives; the public posting of agency MOUs, Business
Plans and Annual Reports; and the submission of agency business plans within 3
months of the end of fiscal.

Clarifications for LHIN Board members: there are some clarifications respecting
appointees and their remuneration. There is no obligation to re-appoint existing
members, no appointee entitlement to severance or termination pay, and
clarifications around terms of remuneration (length of a working day, appointees
are not entitled to reimbursement of professional dues or fees, payments must
only be made to the person named in the appointment instrument and so on).

Of Passing Interest: a number of the new provisions may only be of passing
interest: mandatory requirements for short-term advisory bodies and special
advisors (including rules for remuneration and an ethical framework)
Questions? Email us: [email protected]
31
Risk Management Framework
and
Agency Establishment and
Accountability Directive (AEAD) Risk
Assessments
32
Risk Management Framework and Tools
Embedding Risk
Management
into all Business
Processes
Planning
Risk
INFO
Local
System
Performance
33
Financial
Management
Risk Management Process
State
Objectives
Identify
Risk
Assess
(Measure)
Plan &
Take Action
Monitor
& Report
MOH had adapted the Ontario Public Sector (OPS) Risk
Management Framework (including tools and guidelines for LHINs)
- this method includes non-financial risk specific to healthcare, including risk
impact/likelihood/tolerance
34
Agency Establishment and Accountability
Directive (AEAD) Risk Assessments
Purpose of the Risk Assessments:
 Ensures proactive and strategic agency risk
management
 Establishes ministry’s risk oversight measurements
 Establishes accountability mechanism that
provides due diligence over agency operations
 Allows ministry to better manage corporate risks
and improve oversight
35
AEAD Agency Risk Assessment Template
Risk Description
OPS- Categories of Risk
Instructions:
This section is a guide to describe the Risk being faced by the
organization. Questions that should be answered here include:
1. What is the Risk?
2. What is the source of the risk - that is, what event can trigger the
risk?
4. What is the financial implication of the risk (quantitative or qualitative)
5. Why do you think this is a risk?
Ref
Risk Analysis (H/M)
Objective
#
Likelihood Impact Overall
Risk
Rating
□ Strategic
□ Accountability/Governance
□ Operational
□ Workforce
□ Information Technology & Infrastructure
□ Other
Ministry
Comments
(Risk Description)
* For guidance, see Appendix D for a complete description of
the risk categories
Ministry
Residual Risk Analysis
Comments
Key
Mitigation Target Risk Mitigation Risk Consequence/Impact
(Mitigation Action)
Mitigations
Start
Owner
Status
Date
□ Mandate
□ Financial
Current/
□ Reputational
Proposed
36
AEAD Risk Assessment Anchors - Guide
L
High
i
k Medium
e
li
Low
h
o
o
d
Medium
High
High
Low
Medium
High
Low
Low
Medium
Low
Medium
High
Impact
Anchors (Agency Risk Analysis)
Impact
Very Low
Financial
<=5%
Mandate
100%
Reputational
<1 Mth
Low
Medium
>5%<=10%
High
Very High
>10%<=15% >15%<=20%
>20%
>=90%<100% >=80%<90% >=50%<80%
<50%
>1<=2 Mths
>2<=3 Mths
>3<=5 Mths
Explanation
Percent of Financial Target at Risk of not being achieved
Number of Agency Operational Objectives achieved
>5 Mths Number of months the Agency will have negative news coverage in a year
Anchors (Project Risk Analysis)
Impact
Very Low
Budget
Requirements
<=5%
Time
<1 Mth
100%
Low
>5%<=10%
Medium
High
Very High
>10%<=15% >15%<=20%
>20%
>=90%<100% >=80%<90% >=50%<80%
<50%
>1<=2 Mths
>2<=3 Mths
>3<=5Mths
Explanation
Percent of project cost that exceed project budget estimate
Percent of project requirements completed successfully
37 Time project was completed above estimated project schedule
>5Mths
Identified High Risks & Mitigation
High Risks
Accountability / Governace
• LHIN Operations/Expenses
• Community Engagement
• Planning
• Funding Processes
• Performance Reporting by third
parties.
Operations
• Procurement process compliance
Workforce
• Conflict of Interest
• Code of Ethics policy
Mitigation
• LHIN Board of Directors provides
direction to CEO and LHIN staff in
terms of actions items to be
implemented to manage risk
identified by third party reviews.
• Ensure that all steps taken in each
procurement process has been
completed accurately and all steps
have been noted to the legal
department.
• Employees read and acknowledge
our Conflict of Interest and our Code
of Ethics policy annually through a
formal sign off process on an annual
basis.
38
Identified Medium Risks & Mitigation
Medium Risks
Mitigation
Strategic
• risks related to implementing (or not
implementing) initiatives to achieve
required and desired outcomes
•
LHIN Board reviews/approves Quarterly
Reports (including Risk Reporting and
Risk Summary), and the annual risk
management plan.
Accountability/Governance
• compliance reporting
• legal services (LSB)
• financial reporting
• delegation of authority
• directives, regulation changes
• and failure of health service provider
(HSP) to deliver on commitments
•
Follow-up on non-compliance, review and
seek legal services
Utilize standard templates
Senior management and board to review
financial reporting, clear delegation of
authority established
Review any government policy changes
Regularly review and oversight on HSP
reporting
•
•
•
•
Workforce
•
• External events, often unforeseeable
(such as weather events, political events,
39
significant infection outbreaks)
LHINs regularly engage HSPs, giving all
parties the opportunity to discuss issues
and risks and thereby ensure a collective
focus on system priorities
Community Sector
Funding Allocation
2014.15
Presentation to NELHIN Audit Committee
Kathleen Fyfe, Senior Director System Performance
40
Speech from the Throne
NE LHIN Investment Cycle
Provincial Budget
ADM Funding Letter
Priorities
- IHSP
Decision
to Fund
Monitoring and
Evaluation
of Outcomes
Business Case
- Criteria
Performance
- MLPA
Regional/Local
Tables Support
Planning
- Studies,
Provincial tables
LHIN Officers
41
LHIN Provincial Strategic Framework
A snapshot of Health System Priorities for Ontario and Northeastern Ontario
Improve
Population Health
Improve Experience
with the Health System
42
Improve Sustainability of
the Health System
Putting “Patients First” Means …
Norbert Burgdorf, Barry Lyons, and Mary Coulas,
Patient Advisors with the Sault Area Hospital, have
been able to make changes in the way patients
receive cancer care at the hospital. They spoke at
the NE LHIN’s Patient Engagement Session,
cohosted with the Change Foundation, in May 2014.
•
Supporting people to make
healthier choices and help
prevent disease and illness.
•
Engaging people on health care,
so we fully understand their
needs and concerns.
•
Focusing on people, not just their
illness.
•
Providing care that is
coordinated and integrated, so a
patient can get the right care
from the right providers.
43
What does this means for the North East?
Provincial priorities align well with NE
LHIN’s area of focus:
• Increase ACCESS to care
• Coordination to CONNECT patients/client
to care
• INFORM so people, especially seniors,
make the right decisions about their health.
• PROTECT through quality and evidenced
based care
• Strengthen/Modernize Home and
Community based care
44
In her 80s, Mary Clancy leads Stand
Up Classes for seniors in Sudbury –
55 of 111 new LHIN Funded classes
started in Sept.2014. Mary provided
participant feedback at a planning
meeting last fall.
o Year 3 of our Integrated
Health Service Plan (IHSP)
o Continued focus on 4
priorities –
o
o
o
o
Primary Care
Care Coordination
Mental Health & Addictions
Special Populations
o Continued engagement with
Northerners to develop
priorities for IHSP 2016-2019
45
6
Louise chats with Regional Chief Angus
Toulouse and organizer Edith Mercieca at the
First Nations CSS Summit on Jan. 30, 2015,
in Sudbury.
Strengthening Home and Community Care
• Provincial Panel (April, 2014) - Dr. Gail
Donner, Dr. Samir Sinha, Cathy Fooks,
Donna Thomson, Dr. Kevin Smith and
Joe McReynolds. Report submitted Jan
30, 2015.
• NE LHIN launches survey (Nov. 2014) 10 questions
• 1,009 completed surveys
• 93% from Northerners, not providers.
• Response rate equivalent to 23,500
had the survey gone province wide.
46
What Northerners Want …
•
•
•
•
•
•
Access
Accountability of funding
Coordination and integration
Health human resources
Communication, education and engagement
Cultural diversity and Northern perspective
“Establish a balance between hospital care and community and home
based care. Each has its place and one should not be to the detriment of
the other.”
“Care providers NEED to communicate with one another.”
47
Community Investments
2014/15 Base Allocation - $6.2 M
Service Delivery Enhancements
Enhancement Transportation Services
CSS services (Cochrane)
CCAC
Palliative Care (Algoma Shared Care team)
Mobile Crisis
Stay on Your Feet
Assisted Living (152 clients)
Special Populations - $760,000
Service Integration/System Coordination - $530,000
Primary Care - $372,000
Service Delivery Enhancements - $4,500,000
Special Populations
PSW Training
Geriatric Clinics Coast and Geriatric Services Enhancements
CSS Weenusk & Attiwapiskat
Service Integration
Alzheimer Sudbury, North Bay
Red Cross – First nation development lead
Primary Care
Corner Clinic service expansion and One-time
Service Delivery Enhancements
Enhancement Transportation Services
CSS services (Cochrane)
CCAC
Palliative Care (Algoma Shared Care team)
Mobile Crisis
Stay on Your Feet
Assisted Living (152 clients)
48
Mental Health and Addictions
2014/15 Base Allocation - $2 M
Housing initiatives
• CMHA SSM & SSM Municipal Housing Initiative
• Increased rent supplements across the region
• Nipissing ABI Housing
Housing - $427,000
Service Delivery Enhancements - $622,000
Service enhancements
Peer Support - $19,000
• Supporting Phoenix Rising to find an accessible site
• enhance case management with Nipissing mental health housing &
supports services
• Transitional community support Sudbury
• Transitional Case Management Algoma Public Health
• Enhanced Case Management Mattawa
• Brief intervention case management North Bay
Special Populations - $533,000
Service Integration/System Coordination - $399,000
Peer support
• (PEP) A Peer Support worker for Mattawa & area
Special Populations
• Establish Managed Alcohol Program for chronic alcohol
• Aboriginal Treatment Centre enhanced services
Service Integration/system co-ordination
•
•
•
•
49
Community Mobilization Sudbury
Community Mobilization North Bay
Centralized Access North Shore Tribal Council
North Shore Tribal Council Program Operational review
Evaluation and
Monitoring
50
Evaluation of Business Case Proposals
•
Criteria (Decision Making Framework): Accessible,
Effective, Safe, Patient-Centred, Equitable, Efficient, Appropriately
Resourced, Integrated, Population Health
•
Alignment with LHIN Priorities & Performance:
 What priority of our IHSP does it advance?
 What MLPA metrics will be moved and measured?
•
Connect
•
Planning
51
MLPA Targets for North East LHIN and HUB Hospitals, 2014/15
Report generation date: November 2014 based on Stocktake MLPA Indicators at Q2 2014/15
52
NE LHIN Integrated Health Service Plan (IHSP) Scorecard
Scorecard indicator
Metric
date
Target
Desired
Current direction
Trend
IHSP GOAL 1 - INCREASE PRIMARY CARE COORDINATION
Reduce unnecessary visits to the emergency room that can otherwise
Q4 13/14
14.5%
be supported in primary care
Health Care Connects: Maintain NE LHIN rate of >75% registered
Oct 2014
75%
77%
patients referred to primary care
Health Care Experience Survey primary care attachment results - %
Jun 2014
90%
age 16 + reporting attached to primary care
Health Care Experience Survey primary care attachment result - %
Jun 2014
31%
reporting can get appointment within 48 hrs
IHSP GOAL 2 - ENHANCE CARE COORDINATION AND TRANSITIONS
CCAC service wait time: the “5 day” wait for:
1) nursing;
CCAC service wait time: the “5 day” wait for:
2) personal support for complex clients
Percent ALC days
Q2 2014
90%
95%
Q2 2014
90%
86%
Q1 2014
22%
21.3%
Reduce non-value added time in the emergency room (ER) for
Q2 2014
26.7
patients needing admission: "Time to inpatient bed" - hours
IHSP GOAL 3 - MAKE MENTAL HEALTH AND SUBSTANCE USE TREATMENT MORE ACCESSIBLE
Reduce repeat unscheduled emergency visits within 30 days for
Q1 2014 16.5%
16.2%
mental health conditions
Reduce repeat unscheduled emergency visits within 30 days for
Q1 2014 25.0%
25.7%
substance abuse conditions
Increase telemedicine sites dedicated to mental health and
Q2 2014
8
9
substance abuse.
IHSP GOAL 4 - TARGET NEEDS OF CULTURALLY DIVERSE POPULATION GROUPS
Aboriginal: Improve access by HSPs engaged in cultural sensitivity
training
Aboriginal: Improve access by reducing wait time to mental
health/substance abuse services
Francophone: Increase the number of HSPs designated as providers
of French language services from 40 to 45 - LHIN supported
Francophone: Increase the number of HSPs designated as providers
of French language services from 40 to 45 - Cabinet supported
Goal accomplished
Indicator to be developed
Indicator to be developed
Q2 2014
45
44
45
42
53
Q2 2014
Thank You
Questions?
Quality health
care when
you need it.
Des services
de santé de
qualité au
moment voulu.
Ezhi gshkitoong go
waani zhi mino
yang naadgo
wendming pii ndo
wendaagog
54
Telehomecare (THC) in the
NE LHIN
55
Tamara Shewciw, CIO/eHealth Lead
April 8, 2015
Background
Timmins 2006 pilot
Efficiencies realized in the pilot phase:
•
•
•
•
•
64-66 % decrease in average number of hospital admissions
per patient per month
72-74% reduction in emergency department visits
16-33% decrease in number of primary care physician visits
95-97% reduction in walk-in clinic visits
High levels of patient and provider satisfaction
56
Background
MOHLTC Expansion Project
•
To expand the success of the initial telehomecare pilot
program for chronic disease management to the remainder
of the province, focusing on CHF, COPD, and diabetes
•
Identification of a single host agency within each LHIN that
would be responsible for nurse recruitment, budgeting and
equipment provisioning
•
NE LHIN selected in 2012 as one of three early adopter
LHINs
•
NE CCAC is our host THC agency
57
Overview – What is Telehomecare?
Telehomecare: A Patient Centred Model
Clinician Health Coaching:
Efficient MRP Engagement:
Teaching the Patient how to selfmanage & meet their goals
Clinician provides regular updates,
consults as required
Patient Empowerment:
At home; Sets Personal Goals;
Submits vitals/ health responses
Remote Patient Monitoring:
Simple Technology in Home:
Weekday feeds & Alerts
Tablet, BP Cuff, Scale & Pulse oximeter
58
Overview – What is Telehomecare?
59
5
Current State
8 (of 14) LHINs and over 4500 patients enrolled…
Seven LHINs, 9 Hosts are
Currently Live:
- 5. Central West (William Osler
Health System)
- 7. Toronto Central (CCAC)
- 8. Central (HealthLinks via
-
SouthLake & CCAC)
13. North East (CCAC)
14. North West (CCAC &
TBRHSC)
1. Erie St. Clair (CCAC)
- 12. North Simcoe Muskoka
(CCAC)
LHINs in the Planning Stage:
- 2. South West (CCAC)
6
6
60
Results
Consistent results across LHINs
– 48-56% reduction in ED visits
– 44-57% reduction in Hospital Admissions
TC -reduced ED Visits by 48% and
Hospital Admissions by 44%.
7
7
CW - reduced ED Visits by 56% and
Hospital Admissions by 58%.
61
Central - reduced ED Visits by 48%
and Hospital Admissions by 57%.
Sustained Results, 6 months post
Both CW and TC demonstrate
sustained reduction in ED visits and
hospital admissions -- 6 months
after the completion of the
Telehomecare program.
8
8
62
Telehomecare Patient Feedback
Patient Experience (Toronto Central Results)
– 87% of the patients would definitely recommend the program to others
– 98% agreed that the THC nurses understood what was important to them
– Managing medications properly was the most important patient learning
“I can’t see why anyone wouldn’t
want to try Telehomecare. It was so
simple, so enjoyable to learn. I’d
rather do this than leave it to
chance. It’s my life I’m dealing
with…I’m looking for just a little
longevity. It’s a no brainer.”
- Ian, Telehomecare Patient
9
9
63
64
65
66
67
NE LHIN THC Current Model
14
•
CCAC core team of nurses = 5 FTE (RN & RPN)
•
Partnerships with:
−
Telemedicine Coordinator Nurse (2 sites)
−
Group Health Centre
−
FHTs
•
680 units, evaluating enrolment to provincial asset
management pool
•
Engagement and Physician lead
•
Disease expansion to Diabetes in 15/16 FY, also exploring
Palliative Care, Mental Health and Prevention/Maintenance
68
NE LHIN THC Stats
NE LHIN Status
Current Enrolments in Fiscal Year
Enrolments in Total for the Program
Number of Current Active Patients
611
1,369
368
Referral Source
Hospital
9%
CCAC
60%
Primary Care
26%
Other
5%
Disease Type
15
CHF
49%
COPD
51%
69
Alignment
• Part of Minister’s new Action Plan
• Alignment with healthcare transformation
initiatives including:
− QBPs
− Health Links
− New Integrated Care Models
•
16
Supports and enables NE LHIN Integrated Health
Service Plan (IHSP)
70
QBP
HUB Hospital
– COPD/CHF
Smaller Hospital
Smaller Hospital:
 Low Acuity Pts. discharge from
ED
 Average Acuity Pts. (ward) still
admitted at small hospital
 High Acuity -transfer to HUB ICU
from ED
HUB Hospital:
 Low Acuity Pts. discharge from ED
 Average Acuity Pts. (ward)
admitted
 High Acuity (Vented/Critical Care)
Establish a CHF and COPD
outpatient chronic disease clinic –
goal: reduce readmissions
 Occasional Short BIPAP (6-12 hrs.)
will stay at small hospital
Access to CHF/COPD clinics with
telemedicine suppor t
Standardized Care Plans/Order Sets
Standardized Care Plans/Order Sets
Likely needs CCAC enhancements
and connections to FHT
17
Likely needs CCAC enhancements
and connections to FHT
71
Challenges
• General awareness
• Patient referrals to the program
• NE LHIN specific evaluation
18
72
Collective Opportunity
•
Establish monthly enrolment targets for hospitals based on
their annual CHF/COPD patient admissions / readmission rates
•
Formalize automatic referrals on clinical hospital order
sets/pathways particularly for the emergency departments
•
Leverage QBP process
• Step down for hub COPD/CHF clinics (transition to home)
• Community hospital COPD/CHF clinics
19
•
Align with emerging models of care e.g. HSN Telehomecare
Post-Acute Pilot
•
Align with Health Links by considering “opt-in” model for all
Health Links patients (high % of complex patients tend to have
COPD or CHF)
73
Thank You
Questions?
74
Communiqué to NE LHIN Orthopaedic Surgeons From NE LHIN CEO Louise Paquette
In January 2013, the NE LHIN completed a first-ever Integrated Orthopaedic
Capacity Plan (IOCP) for Northeastern Ontario. The key goals were to
provide evidenced-based data that would help to:
 Reduce wait times for surgeries and increase volumes
 Provide care as close to home as possible
 Deliver quality-based care
Key strategies to achieve these goals included:
 Increase volumes to repatriate patients who left the NE LHIN for surgery
 Improve reporting of data by surgeons
 Enhance the role of the North East Joint Assessment Centres (NE JAC)
 Improve rehabilitation services
February 2015
Percentage of non-urgent hip
and knee replacements
completed within Provincial
access target of 182 days
Then (Dec 2012)
Now (Dec 2014)
100%
71%
50%
79%
73%
57%
0%
Strategy 1: Increase volumes to repatriate patients





Overall the NE LHIN has increased the volume of hip and knee
replacements by 15% since 2012/13 resulting in 654 more surgeries.
Hospitals in the NE LHIN have consistently performed below the 4.4 day
target for average length of stay for hip and knee replacements.
Hospitals in the NE LHIN have consistently performed above the 90%
target for the percentage of patients discharged home after hip and knee
replacement surgery.
Wait times for knee replacements has almost halved from 409 days (90th
percentile) to 258 and hips wait times have reduced from 279 to 206.
Almost 80% of hip surgeries are making the target of 182 days (vs. 71% in
2012) and 73 % of knees (vs. 53% in 2012).
Hips
Knees
Wait time (days) for hip and
knee replacements
90th percentile wait (days)
The NE LHIN is pleased to provide you with this two-year update on the
progress that has been made. Your efforts in your daily practice to achieve
the strategies outlined above are making a difference. While more work
remains to be done, the progress made thus far is allowing Northerners to
get the care they need more quickly and efficiently – system progress that
is benefitting people living in Northeastern Ontario! Thank you in advance
for staying focussed on your efforts to move these strategies forward.
Then (Dec 2012)
Now (Dec 2014)
500
400
409
300
200
279
258
206
100
0
Hips
Knees
Unilateral Hip and Knee
Replacements
Hips
Knees


In 2009, 56% of primary hip replacements for local residents were
completed in NE hospitals compared to 82% in 2014.
Similarly for primary knee replacements, 69% were completed in NE
hospitals compared to 83% in 2014. While there is still work to do, there
has been a marked improvement in providing care closer to home.
75
# of surgeries
2000
In 2009 the NE LHIN identified the need to treat people as close to home as
possible and started focussing efforts to repatriate hip and knee surgeries to
hub hospitals.
1500
1000
500
1,277
555
1,468
640
1,468
742
0
2012/13
funded
2014/15
funded
2014/15
planned
Strategy 2: Improve reporting of data by surgeons


NE LHIN hospitals have worked closely with surgeons’ office staff to
ensure timely and accurate data is submitted to Cancer Care Ontario’s
Wait Time Information System. In addition, hospitals engage with their
surgeons to review wait time and OQS data. The NE LHIN’s Wait Time
and Volumes Subcommittee meets quarterly to review performance with
hospital leadership and make recommendations for improvement.
The importance of good data to continue to drive evidence-based results
cannot be overstated. Your efforts in this regards are both paramount
and appreciated.
% of primary hip and knee
surgeries completed in the NE
LHIN for NE residents
% hips
% knees
100%
80%
82% 83%
60%
40%
69%
56%
20%
0%
2009
NE JACs provide a centralized, coordinated access point for patients with
conditions such as osteoarthritis to be assessed for joint replacement surgery
and are now seen as best practice.

The NE JACs have completed over 19,000 assessments and currently
67% of assessed patients do not require a surgeon’s consultation.

The success of the JACs with hip and knee replacement has led to the
expansion of the assessment program to shoulders in 2014, consistent
with the goals of the IOCP.
NE JAC Assessments and % of
patients not requiring surgical
consult
Assessments
% NOT resulting in surgeon consult
# of assessments
JACs for hip and knee replacement were established in the five surgical
hospitals in the NE including: Health Sciences North, North Bay Regional
Health Centre, Sault Area Hospital, Timmins and District Hospital and the
West Parry Sound Health Centre. Staffed by Advanced Practice
Physiotherapists trained by local surgeons and supported by administrative
staff, the JACs ensure that patients who need surgery are sent to surgeons
for consultation and those patients who could benefit from other strategies
to stabilize/improve their condition receive those interventions.
2014
7000
67%
6000
53%
5000
6,618
4000
5,820
3000
4,606
2000
1000 2,729
0
80%
70%
60%
50%
40%
30%
20%
10%
0%
% of patients no consult req'd
Strategy 3: North East Joint Assessment Centres (NE JACs)
Strategy 4: Improve Rehabilitation Services
Access to timely rehabilitation is key for successful patient outcomes after
hip and knee replacement surgery. In the NE LHIN, rehabilitation can be
provided by:



the NE CCAC through homecare assessment and service provision;
hospital-based inpatient rehabilitation and/or outpatient programs;
patient access to third-party (private) physiotherapy.
76
In 2012, the NE LHIN established its Local HSFR
Partnership consisting of NE clinical and
administrative leadership to be the steward of
implementing Quality Based Procedures (QBP).
One of the first tasks was the review of and
implementation of the NE LHIN’s Clinical
Services Review (CSR). The CSR provided
recommendations on the implementation of
clinical handbooks for each QBP including hip
and knee replacements. Over the past year the
Local Partnership continues to steer the
implementation process.
Physio Reform Funding
In all 29 clinics in the NE LHIN (16 community-based;
12 hospital-based and 1 CHC) received a portion of
5372 Episodes of Care (EoC) to provide outpatient
physio to patients meeting criteria, which includes
people recently discharged as an inpatient of a
hospital and in need of physiotherapy clinic services.
Note that post hip and knee replacement patients
can qualify for this service.
Third-party (private) Physiotherapy
There are no databases enabling comparison of
patient experience over time concerning third party
private physiotherapy for rehabilitation related to joint
replacements. EoC reporting from private community
physiotherapy clinics and hospital based EoC funded
clinics is just underway. LHINs will be in receipt of
data by 2015/16 which will provide information on the
types of patients and services provided.
NE CCAC support to hip and knee replacement
rehabilitation
Hips
1200
1,237
1,208
1,134
1000
800
600
400
717
686
627
507
551
472
200
0
2012/13
The NE LHIN has embarked on a comprehensive
review of rehabilitation services in-sync with provincial
directions through the Provincial Rehabilitative Care
Alliance. Planning for rehabilitation includes ensuring
linkage to and coordination with QBP planning.
The NE LHIN’s Clinical Services Review compared
current practice in discharge of joint replacement
patients to inpatient rehabilitation to proposed
provincial targets.

Total
1400
Inpatient Rehabilitation

Knees
Currently 0.5% access inpatient rehab. The
Province’s target is 10%. Planning for enhanced
rehabilitation across the NE LHIN is taking these
stats into consideration.
The goals of the review of rehabilitative care
include evaluating alignment in the NE LHIN with
standardized definitions for inpatient bedded
levels of care as well as community-based levels
of rehabilitative care across the continuum. Joint
replacement and where it “fits” in this continuum
is an important component of the review and
subsequent system planning.
77
2013/14
2014/15 (projected
from Q2)
ITEM # 13
NORTH EAST LHIN BOARD OF DIRECTORS BRIEFING NOTE
2015-16 LHIN OPERATIONS BUDGET
2015-03-27
Marc Demers
PROPOSED RESOLUTION/MOTION:
WHEREAS the 2015.16 NELHIN Operations Budget incorporates the planning targets
for the year;
WHEREAS the financial plan will be revisited and revised to align with the approved
operating allocation once confirmed;
BE IT RESOLVED THAT:
The North East LHIN Board of Directors received and approved the NELHIN
Operations Budget for the 2015-2016 fiscal year as presented on April 7, 2015.
BACKGROUND:
Budget Development Process
The NELHIN Annual Budget consists of revenues and expenditures in the amount of
$7.8 million. The budget plan sets out a balanced operating position.
The operating plan was developed based on financial assumptions giving consideration
to the following:
• Prior year activity and actual operating performance
• No adjustment to funding sources
• Adjustment to operating expenditures for known contractual obligations and
inflation
The schedule of revenue and expenditures by category with a comparative to prior year
budget and actual operating positions, are provided below. Key variances include the
following:
78
•
•
•
One-time capital cost of $92.7k to renovate (reduce office space) the North Bay
office will equate to $66k in annualized lease cost reduction
Additional $30k in LSSO Shared Costs committed from all LHINs
Additional $30k in Translation required based on new shared translation agreement
ANALYSIS:
REVENUE
SALARY & WAGES
TRANSPORTATION & COMMUNICATION
SERVICES
SUPPLIES & IT
TOTAL OPERATIONAL EXPENSES
SURPLUS/(DEFICIT)
2013-14
Actual
2014-15
Budget
2014-15
Actual
(Projected)
2015-16
Proposed
Budget
7,747,312
5,515,798
311,557
1,825,120
94,837
7,747,312
-
7,868,301
5,735,277
315,000
1,778,024
40,000
7,868,301
-
7,856,972
5,673,812
300,000
1,831,160
52,000
7,856,972
-
7,775,601
5,644,846
320,000
1,770,755
40,000
7,775,601
-
Proposed
Budget
Increase /
(Decrease)
(92,700)
(90,431)
5,000
(7,269)
(92,700)
-
KEY MESSAGES:
•
•
•
Total revenue and expenses unchanged from previous budget year
Cash flow will be monitored closely early in fiscal year due to delay in initiative
funding and additional expenditures related to North Bay office renovation expected
to be due in near the end of Q1
The budget plan will be revisited once funding confirmation is received, planned
adjustments will be incorporated to align to the approved operating allocation
NEXT STEPS:
•
•
•
Implement approved budget and finalize monthly distribution
Communicate cash flow concerns with LLB and MOH
Incorporate required changes to budget resulting from Ministry funding confirmation.
Reference Documents
•
2015-16 Budget
79
RESOLUTION
MOVED:
_____________________________________
SECONDED:
_____________________________________
RESOLVED THAT:
“The members attending this meeting move into a Closed Session pursuant to the following exceptions of
LHINS set out in s.9(5) of the Local Health Integration Act, 2006.”
☐ Personal or public interest
☐ Public security
☐ Security of the LHIN and its directors
☐ Personal health information
☐ Prejudice to legal proceedings
☐ Safety
☐ Personal matters
☒ Labour relations
☐ Matters subject to solicitor client privilege
☐ Matters prescribed by regulation
☐ Deliberations on whether to move into a Closed Session
BE IT FURTHER RESOLVED THAT; the following persons be permitted to attend:
Louise Paquette, CEO
Kate Fyfe, Senior Director
Martha Auchinleck, Senior Director
Terry Tilleczek, Senior Director
Cynthia Stables, Director
Tamara Shewciw, Chief Information Officer
Micheline Beaudry, Executive Assistant to the CEO and Board Liaison
_________________________________
Chair
80
RESOLUTION
Motion No.: 2015-BD00xx
MOVED:
_____________________________________
SECONDED:
_____________________________________
RESOLVED THAT:
The Board of Directors of the NE LHIN received the report of its Closed Session meeting of April 8, 2015.
_________________________________
Chair
81
Resolution
North East Local Health Integration Network (the “Corporation”)
MOVED:
_____________________________________
SECONDED
_____________________________________
RESOLVED THAT:
The North East LHIN Board of Directors meeting of Wednesday April 8 be adjourned at ____________.
_________________________________
Chair
82

the NE LHIN Board of Directors Package

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