Mississauga Halton LHIN CSS and MH&A Sector Meeting June 11, - - PowerPoint PPT Presentation

Mississauga Halton LHIN CSS and MH&A Sector Meeting June 11, 2010

Agenda

Agenda

Welcome and Agenda Community Care Information Management Program (CCIM)

• Human Resource Information System (HRIS)

Presentation Herb Spence – Stakeholder Engagement, HRIS Eugene Cortes - Project Lead, CMH&A Sector, HRIS Sajneet Sodhi – Project Lead, CSS Sector, HRIS 60 min Mississauga Halton LHIN ReCharge Program Kristina Hall, Executive Director Nucleus Housing 15 min ~ BREAK ~ 15 min CSS – Common Assessment Project (CAP) Alan Fleming – Implementation Lead Ashim Rizki – Project Lead, CCIM, MH and CW LHIN 20 min Finance Update Paulette Zulianello, Senior Lead, Funding and Allocation, MH LHIN 10 min MH LHIN Strategic Investments:

• Aging at Home Update

Narendra Shah, COO MH LHIN 35 min Integration Feedback and Exercise (as per attached feedback focus on 2 areas for discussion: training and back office integration) Angela Jacobs, Senior Lead Performance and Integration, MH LHIN 15 min Canadian Red Cross Update Valerie Cook, Integrated Manager Canadian Red Cross CHS 5 min Questions/Comments Next Meeting: September 10, 2010 Angela Jacobs 5 min

Community Care Information Management Program (CCIM) Human Resource Information System (HRIS) Presentation

Herb Spence Eugene Cortes Sajneet Sodhi

4

Welcome!

5

Community Care Information Management

HRIS PROJECT

CSS and CMH& A Sectors

June 2010

Presentation Agenda

• Introduction & Overview
• HRIS Project Background & Solution Overview
• Benefits and Implementation Process
• Training & Communications
• HRIS Support Centre, LHIN Summary and Next

Steps

• Q&A

7

Introductions

• Herb Spence, Stakeholder Engagement/Business

Relationship - CSS & CMH&A Sectors, HRIS Project

• Sajneet Sodhi, Project Lead –

CSS Sector, HRIS Project

• Larry Radzio, Implementation Lead –

CSS Sector, HRIS Project

• Paolo Primiani, Implementation Lead –

CMH&A Sector, HRIS Project

Presentation Objectives

• Provide a high level overview of the Community Care

Information Management (CCIM) program

• Introduce the Human Resources Information Systems (HRIS)

project and the benefits of participating

• Discuss the implementation and training process

Community Care Information Management (CCIM)

“CCIM strives to improve client outcomes by efficiently delivering the right community health service at the right time.”

• Two major project streams designed to address sector priorities
• Aim to create universally acceptable clinical and business standards across the

sector and have the potential for cross-sector application

BUSINESS SYSTEMS COMMON ASSESSMENTS

Standards, processes and tools to collect financial and statistical data, including human resources and payroll Tools to facilitate the collection and use of client information Used for evidence-based decision support for planning, integration and funding of community services Create a sustainable approach to managing and measuring improvement in client

• utcomes over time

Infrastructure & Operations Standards Security, Privacy & Risk Management Transition

Community Care Information Management (CCIM) Program

CCAC CSS CMH&A LTCH CHC SCCH

Local Health Integration Networks (LHINs)

Integrated Data Strategy Common Assessment Business Systems

Common Intake Assessment Tool Long Stay Assessment Software Management Information Systems Human Resources Information Systems Management Information Systems Human Resources Information Systems Management Information Systems Human Resources Information Systems Management Information Systems Human Resources Information Systems Common Assessment Ontario Common Assessment

• f Need

Resident Assessment Instrument MDS 2.0 Management Information Systems

Completed and transitioned Initiation stage Pilot stage Currently rolling out CCAC = Community Care Access Centres CSS = Community Support Services CMH&A = Community Mental Health and Addictions LTCH = Long-Term Care Homes SCCH = Small & Complex Continuing Care Hospitals CHC = Community Health Centres

Management Information Systems Integrated Assessment Record

HRIS Project Background

• Initiated by the Ministry of Health and

Long-Term Care (MOHLTC) in August 2008

• Supports both the Community Mental

Health and Addictions (CMH&A) and the Community Support Services (CSS) sectors with a HR and Payroll software solution, Quadrant

– Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector

• Organizations have been receiving

training since February 2009

• Implementation with organizations

began in March 2009

HRIS Project Milestones

Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10 Sep-08

MOHLTC Project Announcement Software Solution RFP Issued Initial Announcement to Sectors HRIS Training HRIS Implementation Creation of Advisory Working Groups Launched HRIS Support Centre 50th Organization Fully Implemented Launched HRIS Webinar Series

Classification: Medium

13

HRIS Solution Overview

• Quadrant is composed of a variety of modules:

– Human Resources – Payroll – Scheduling – Self Service including QHRnet

• Hosted in a secure, central environment
• CCIM is responsible for:

– Back-up & maintenance – Applying patches and releases (i.e. tax updates)

• Solution meets all relevant security & privacy

regulations

• Organizations own and ONLY have access to their

data

• Participating organizations receive a lifetime

license for Quadrant

Quadrant Modules

Human Resources

• Captures employee demographics
• Position-centric design and

management

• Configurable form templates and

process checklists

• User and system based notifications

Payroll

• Ability to generate manual and

automated time cards

• Pay cycle management
• Ability to adjust earnings, deductions

and allowances

• Efficient manual, automatic, special

and retro pay processing

Scheduling

• Easy schedule creation and

administration

• Applies to organizations with simple
• r complex scheduling rules
• Compatible with multi-site, multi-

position and/or multi-union work environments

Self Service including QHRnet

Employees have the ability to:

• View and edit personal

demographic information

• View and print pay statements
• View and print work schedules
• View and track benefit banks

** A 20 minute Software Demo is in the package provided to you

Benefits of Implementing the HRIS Softw are Solution, Quadrant

 Automates and streamlines HR and Payroll processes

• Manual processes are automated,

leading to better use of time and resources

 Allows for efficient OHRS data collection and reporting

• Reduces back-office duplication
• Ensures the information is provided in

the right format to MOHLTC and LHINs

Benefits of Implementing the HRIS Softw are Solution, Quadrant (continued)

 Interfaces with the financial and statistical management solution

• Organizations can export human resources

and payroll data and interface it with Microsoft Dynamics GP

• Compatibility with 3rd party applications

using generic interfaces –minimum configuration effort to import as well as export data from and to other applications

 Provides evidence-based information for system planning

• Organizations will have the ability to

generate reliable reports for resource planning, data collection and information management

HRIS Project Eligibility

• CMH&A and CSS organizations are

eligible to participate

• Organizations must have submitted a

successful Ontario Healthcare Reporting Standards (OHRS)/MIS Trial Balance

• Organizations are encouraged to implement the software however

it is not mandatory

• Current project end date is March 2012

18

Typical HRIS Project Implementation Process

Step 1 Step 8 Step 9 Step 4 Step 5 Step 6 Step 7 Step 2 Step 3

Go- Live!

Participate in Parallel Testing Configure Application Database Complete HR & Payroll training sessions Complete Implementation Project Plan Participate in Kick-Off Call Complete Connectivity Test E-mail confirmation

• f participation

HRIS Project Life Cycle

Start working together on Starter Kits 1, 2 and 3 “Live” Support for participating

• rganizations

19

Implementation - Testimonials

“The implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner. We look forward to our continued relationship and utilizing the software’s full benefits”

– Karen Cutmore, Support and Housing Halton

“Great news! Upload was successful. Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP. Worked like hot knife cutting through butter – so easy.”

– Victoria Best, Links2care

HRIS Project Training

• Training customized to:

– Reflect requirements of the sector – Suit organizational needs

• Courses currently available:

Human Resources (mandatory) 2 days Payroll (mandatory) 3 days Year End Payroll (optional) 1 day Report Writing 1 (optional) 3 days HR Suite (optional) 2 days Scheduling (optional) On Demand QHRnet Basic, End-Users and Admin Just-In-Time (Online, CD)

• Future courses

QHRnet Leave Management (optional) To be determined

21

Training - Testimonials

“We are ready for live implementation of QHR this week. The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do. The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs, hours, etc. The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balances.”

• Sheryl Niemienen, S.E.N.A.C.A. Seniors Day Program

“It is an excellent training session. It's clear a lot of work was done in

• preparation. It's a lot of material to cover and I feel like I've at least got a

good start on the implementation.”

– Susan Buono, Summit House

Communications

• Information sessions are held across

all 14 LHINs. Recently, we presented to CMH&A and CSS organizations in HNHB and South West LHINs.

• Webinar presentations for
• rganizations interested in the HRIS

project (over 140 CMH&A and CSS participants registered for four webinar sessions)

• Quarterly newsletters designed to

provide the latest information as well as lessons learned and testimonials to all CMH&A and CSS organizations. *A Systems for Success newsletter was sent to all organizations and LHINs in March 2010

HRIS Support Centre

“Live” support available 8:00 AM – 6:00 PM EST except on weekends and holidays To contact the HRIS Support Centre: CSS css.hris@ccim.on.ca 1-877-706-8094 CMH&A cmh_a.hris@ccim.on.ca 1-877-706-8095

24

Support - Testimonials

“Thank you very much for all the help last week on our manual payment for vacation payout. I appreciate all that the support team have done for us, the support team really went above and beyond. The vacation pay also went through and all my co-workers thank the support team.”

– Katalin Majoros, Seniors Life Enhancement Centres

“I need to point out how excellent the Support Center is. They are very polite, with an excellent response time.”

– Dipika Nayar, Hospice of Peel (HeartHouse Hospice)

25

Participating Organizations To Date

• Participating organizations range in size (small,

medium and large), provide a variety of services and vary in degrees of complexity

• 98 CMH&A and 112 CSS organizations have

implemented or are currently implementing Quadrant across the province across all 14 LHINs

• Of these, 46 CMH&A and 60 CSS have

implemented the HRIS software solution, Quadrant

26

MH LHIN HRIS Summary (as of May 2010)

Community Mental Health and Addictions (CMH&A)*

• In total, there are 9

CMH&A organizations in the MH LHIN

• 2 organizations are currently implementing the HRIS

software solution, Quadrant

• 4
• rganizations are fully implemented with Quadrant

* Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN

Community Support Services (CSS)*

• In total, there are 33 CSS organizations in the

MH LHIN

• 3
• rganizations are currently implementing the

HRIS software solution, Quadrant

• 7
• rganizations are fully implemented with

Quadrant

Next Steps

• Talk to CMH&A and CSS organizations about their

experiences implementing Quadrant

• For more information or if you would like to sign-up for

the HRIS project, please contact Saj

• The project lead will reach out to your organization to

answer any questions

29

Appendix

• CMH&A Organizations Implemented and Implementing

Quadrant

• CSS Organizations Implemented and Implementing

Quadrant

• Number of CSS and CMH&A Organizations Currently

Implementing Quadrant by LHIN

• Sample list of User Defined Folders (UDFs)
• Sample list of Checklists
• Sample list of Reports
• Case Study: St. Joseph’s Home Care

29

30

CMH& A Orgs Implemented & Implementing Quadrant in the MH LHIN (as of May 2010)

Sector Organization Implemented Implementing CMH&A Halton Alcohol and Drug Assessment Prevention and Treatment  Halton Recovery House  Hope Place Women's Treatment Centre  Summit House  Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated  Supported Training and Rehabilitation in Diverse Environments 

31

CSS Orgs Implemented & Implementing Quadrant in the MH LHIN (as of May 2010)

Sector Organization Implemented Implementing CSS Dixie Bloor Neighbourhood Drop-In Centre  Hospice Of Peel Inc.  Links2care (Georgetown)  Nucleus Independent Living Inc.  M.I.C.B.A Forum Italia Community Services  Peel Cheshire Homes Inc. (Streetsville)  Peel Senior Link  Rehabilitation Foundation For The Disabled - Peel Region  S.E.N.A.C.A. Seniors Day Program - Halton Incorporated  Seniors Life Enhancement Centres 

32

Number of CSS and CMH& A Organizations Currently Implemented and Implementing Quadrant by LHIN

32

LHIN # # of CSS Organizations # of CMH&A Organizations Total per LHIN LHIN Name LHIN 1 9 11 20 Erie St Clair LHIN 2 5 10 15 South West LHIN 3 3 4 7 Waterloo Wellington LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant LHIN 5 5 2 7 Central West LHIN 6 10 6 16 Mississauga Halton LHIN 7 10 9 19 Toronto Central LHIN 8 8 2 10 Central LHIN 9 10 7 17 Central East LHIN 10 6 5 11 South East LHIN 11 8 11 19 Champlain LHIN 12 10 4 14 North Simcoe Muskoka LHIN 13 5 10 15 North East LHIN 14 2 5 7 North West Total all LHINs: 112 98 210

Sample List of User Defined Folders (UDFs)

New Hire

– Benefits Enrollments – Code of Conduct – Criminal Records Check – Employee Photo – Letter of Offer – Foreign Workers – Reference Check

Education

– Education Funding – HCA Challenge Program – Regional Orientation – Succession Planning or Staff Development Plans

Performance Management

– Arbitration – Attendance Management – Disciplinary Actions – Grievance – Performance Review/Appraisal – Probationary Review

Human Resources

– Exit Interview – Increment Dates – Recruitment & Retention Grants – Trial Period – Transfers – Vacation Increments

Sample List of User Defined Folders (UDFs) continued…

Health & Safety

– Annual Staff Immunization – Drug Screen – HepB Immunization – Incident Report – TB Immunization – Occ Health Form – Vision Testing

Leave Management

– Disability Rehab – Duty to Accommodate – Leave of Absence – MPIC – Return to Work – WCB/Critical Job Injury/Health & Safety Incident

Employer Property

– Building Security – Equipment Repair/Replace – Facility Property-Employers – Insured Driver List

Service Recognition

– Rewards & Recognition Reward – Service Awards

Sample List of Checklists

– Submit Request for Hire to HR – Schedule Orientation – Verify Qualifications – Prepare & Send Offer Letter – Approved Staffing Request Form – Schedule Appointments – Hire Application in QHR – Administer TB Tests – Add Immunization History – Add Criminal Code UDF – Add Probationary UDF – Confirm Orientation Completion – Take Employee Photo – Confirm Hire Date – Schedule Benefit Appointment – Enter Probationary Period – Enter Employment Info – Enter Payment Info – Enter Contact Information – Enter Position & Remuneration – Enter Deductions & Benefits – Complete Employee File

Sample List of Reports

– Assigned Position Report – Banks EE Benefit Report – Contacts Report – Deleted Leave Request Report – Demographic – Direct Deduction Range Report – Employee Banks – Employee Birthday by Month Report – Employee Class – Employee Hire Report – Employee Information Report – Employee Pension Rate Report – Employee Status Report – Employee Termination Report – Federal Provincial TD1 Report – PA T4 Exception Report – Pension Annual Report – Withholding Report – Allowances Setup Report – Banks Setup Report – Chart of Accounts Report – Checklist Report – Competencies Configuration – Deductions Setup Report – Master Position Vacancy Report – MOH Headcount – Notification Group Addresses – Occupation and Pay Scales – Availability by Position Report – Available Shifts Report – Basic Schedule Filter – Daily Staffing Analysis – Filter Schedule by Open Shifts – EFT File Summary Report – Employee T4 – Employer T4

Case Study: St. Joseph’s Home Care,

Hamilton

Presented by Steve Moore, Manager, Business & Systems, St. Joseph’s Home Care

Who is St. Joseph’s Home Care?

• A member of the St. Joseph’s Health System, which

includes:

–

• St. Joseph’s Villa

–

• St. Joseph’s Healthcare Hamilton

–

• St. Mary’s Hospital Kitchener

–

• St. Joseph’s Health Centre Guelph

–

• St. Joseph’s Life care Centre Brantford
• Our part of the continuum of care is Home Care.
• Our programs include:

– Visiting, Shift, and Specialty Nursing contracts with the HNHB CCAC – PSW/ HSW Supportive Housing programs – PSW Specialty programs, such as Constant Care & Caregiver Relief

Why did w e choose to implement the Quadrant HRIS Solution?

1. Faced with OHRS Reporting 2. No existing system to track and report on earned hours or other statistics 3. Existing payroll/ HR solution high processing fees, but limited benefits 4. Hours to be paid keyed in as totals per pay period, making monthly reporting and analysis difficult. With labor being our major cost, imprecise accruals made variance reporting difficult 5. Tracking and reporting of banks, such as vacation and sick time was very manual 6. In a four union environment, seniority calculations were a real chore 7. No opportunity to import timecard data 8. Applying pay rate increases mid-pay period was a lot of work 9. Poor centralized HR functionality 10. Poor reporting on payroll/ HR data

Our Implementation Process

• Initial contact with CCIM –

March, 2009

• Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutions
• Decided to proceed with HRIS (Quadrant) solution first
• Implementation consultants assigned and project plan created –

June/ July, 2009

• Go Live target set for first pay period in 2010
• First training HR and Payroll –

Project Lead – Steve Moore – June, 2009

• Main training for three staff HR and Payroll –

September, 2009

• HR Suite Training –

Project Lead – Steve Moore – November, 2009

• Configuration complete by Mid-November, 2009
• Parallel testing complete by Early December, 2009

– Simulated parallel run. Actual payroll from old system re-processed in Quadrant

• n an off-week.
• Go Live successful on target!!
• Report writer 1 training –

Project Lead – Steve Moore – February, 2010

What is next?

• Implement HR Suite functionality:

– Competencies – User Defined Folders – Checklists – Notifications

• QHR Net, which provides for:

– Internet access for employees to pay statements – Opportunity to allow employees to update their own demographics

• Demonstration on Training and Scheduling modules
• Advanced Report Writer training
• Ongoing membership in HRIS Advisory Working Group

Challenges

• TIME !!
• Chart of Accounts:

– OHRS Restrictions – Understanding the algorithms used in Quadrant processing – Because Dynamics GP not implemented first, there was a need to negotiate back and forth between HRIS and MIS Implementation teams

• Lack of Configuration training up front
• Lack of technical documentation

Rew ards

• Trainers are experienced and excellent and the training

materials used were actually produced by those same trainers

• Trainers use “Parking Lots”

when they cannot answer questions, then they get the answers and provide them in class, or if necessary, via email if the class has already finished

• Strong implementation Teams

– Some you meet – Some you don’t

• Experienced implementation teams bring strong actual

experience and methodologies

• Very good help desk. Support personnel strong on payroll &

HR processes, with available more technical support when needed

Summary

• Our entire list of concerns over our old solution have been

resolved with Quadrant, but specifically:

– Of 290 employees, we efficiently import payroll data for all but 6 – We have vastly improved payroll related controls, thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant – We can now easily apply mid-pay period rate increases

• We expect to Go Live with Dynamics GP in late summer
• We look forward to working with features of Quadrant that will

be a bonus for us:

– HR Suite – QHR Net – Training module – Scheduling module – Other modules that may come – Advanced Report Writer training

Contact Information

• You will find that CCIM has a strong HRIS

implementation and training team, however, if I can be of any assistance:

• I am an active member of the HRIS Advisory

Working Group

• You can also contact me at:

– smoore@stjhc.ca – Phone (905) 522-6887, ext 2254

Thank You

Mississauga Halton LHIN ReCharge Program

Kristina Hall

Break

15 Minutes

CSS – Common Assessment Project (CAP)

Ashim Rizki Allen Flaming

Presentation for CSS & MH&A Sector Meeting June 11th, 2010

CSS CAP Project

CSS CAP Project

CSS Cap Project

CSS CAP Project

Project Team for Community Care Information Management (CCIM)

• Ashim

Rizki, Project Lead – MH & CW LHINs

• Allen Flaming, Implementation Lead – MH LHIN

LHIN Project Team

• Judy Bowyer, MH LHIN
• Priti Patel, MH LHIN
• Steering Committee – MH LHIN CSS Providers

Infrastructure & Operations Standards Security, Privacy & Risk Management Transition

Community Care Information Management (CCIM) Program

CCAC CSS CMH&A LTCH CHC SCCH

Local Health Integration Networks (LHINs)

Integrated Data Strategy Assessment Projects Business Systems

Common Intake Assessment Tool Long Stay Assessment Software Management Information Systems Human Resources Information Systems Management Information Systems Human Resources Information Systems Management Information Systems Human Resources Information Systems Management Information Systems Human Resources Information Systems interRAI Community Health Assessment Ontario Common Assessment

• f Need

Resident Assessment Instrument MDS 2.0 Management Information Systems

Completed and transitioned Initiation stage Pilot stage Currently rolling out CCAC = Community Care Access Centres CSS = Community Support Services CMH&A = Community Mental Health and Addictions LTCH = Long-Term Care Homes SCCH = Small & Complex Continuing Care Hospitals CHC = Community Health Centres

Management Information Systems Integrated Assessment Record Screening Capability

Referral Screener Tool Self administered or org administered Service Planning Right Service for Right Client Data Sharing Data Submission More intensive services

Supportive Housing Adult Day Program Need for a comprehensive assessment

Less intensive services

Meals Delivery Transportation Drop-in Centre

Outcomes

Out of SCOPE In SCOPE

Reports Data Management

CSS CAP project scope

How we are working in partnership

Information Management Alliance CSS CAP Steering Committee

Working and Reference Groups

LHIN Implementation Steering Committees

LHIN n etc. Mississauga Halton LHIN Consent Management Aboriginal Data Mgmt Mobility Shared Ax Reports Best Practices -DQ Education Screener Cross Sector

Common Assessment PROJECT TEAM

Project Management BusinessProcess Education Implementation Communications

CSS CAP implementation model

CSS CAP Project – Next Steps

CSS CAP Project

CHOICES – ALL @ Same Time

CHOICES – GROUPS @ Differing Times

Take Away Considerations

Take Away Considerations

MHLHIN Financial Update

Paulette Zulianello, Senior Lead Funding and Allocation

TRAINING

• Took place June 4th

to June 10th

• 2 more in case you have missed out
• CMH&A –

June 15th 12:00 to 1:30 pm

• CSS –

June 16th 9:30 to 11:00 am

• Last Chance

Q4 CAT Reporting and ARR

Tips and Tools

• Reminder –

Follow each step in sequence

• Q4 flat file must successfully upload to WERS before

working on ARR ( keep both open until complete)

• Use CAT version 2.5 not 2.1
• Print entire report not each page
• Community Analysis Tool (CAT User Guide 3.0)

(troubleshooting pg 61)

• CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
• ARR HSP Guide V1.1
• `

...Tips and Tools (cont’d)

• Auditors can print Auditor’s Report on own

Letterhead

• No exception in 2009/10 –

all must procure Audit’s Report

• Accrual information not required
• No ARR statistics –
• nly Q4 CAT
• Make sure required variances are explained

...Tips and Tools (cont’d)

• Technical contact –

Kim.Hewitt@ontario.ca

• CMH&A ARR contact –

Vivian.Tsang@ontario.ca

• CSS ARR contact –

Kelvin.Wong@ontario.ca

• Mirella and myself
• Q4 and ARR –

due June 30

• Supplementary Reporting for Initiatives-

June 30th

HST is coming July 1, 2010! Harmonized Sales Tax Simple Comparison

Today July 1 Sale $100.00 $100.00 GST 5% 5.00 PST 8% 8.00 HST 13% 13.00 Total $113.00 $113.00

Example: PST-Taxable Purchase

Today July 1 Purchase $100.00 $100.00 GST 5% 5.00 PST 8% 8.00 HST 13% _______ 13.00 Total $ 113.00 $113.00 GST Rebate 50% (2.50) (2.50) HST Rebate 82% _______ (6.56) GST/HST rebate (2.50) (9.06) NET COST $110.50 $103.94

Example: PST-Exempt Purchase

Today July 1

Purchase $100.00 $100.00 GST 5% 5.00 PST 8% HST 13% ________ 13.00 Total $ 105.00 $113.00 GST Rebate 50% (2.50) (2.50) HST Rebate 82% ________ (6.56) GST/HST rebate (2.50) (9.06) Net cost $ 102.50 $103.94

Combined Rebate Factor: Ontario

July 1

Purchase $100.00 HST 13% 13.00 x 69.69% = 9.06 Total $113.00 GST Rebate 50% (2.50) HST Rebate 82% (6.56) GST/HST rebate (9.06) Net cost $103.94

Net impact of HST (Incremental Effect)

• PST-

taxable: 110.5→ 103.94 6.56% decrease

• PST-

exempt: 102.5→ 103.94 1.44% increase

What's Taxable Under the HST and What's Not?

Clothing and Footwear

GST-taxable before July 1, 2010 PST-taxable before July 1,2010 Is there a change to the amount of tax payable under the HST? Adult Clothing 5% 8% No (remains 13%) Children's Clothing 5% No PST No (remains 5%) Shoe Repair Service 5% 8% No (remains 13%) Children's Footwear 5% No PST if $30 or less No for footwear up to size 6 (remains 5%) Tailoring Services 5% 8% No (remains 13%) Dry Cleaning Service Dry Cleaning Service 5% 5% No PST No PST Yes (changes to 13%) Yes (changes to 13%)

What's Taxable Under the HST and What's Not…cont’d

Food and Beverages

GST-taxable before July 1, 2010 PST-taxable before July 1,2010 Is there a change to the amount of tax payable under the HST? Basic Groceries (e.g., Dairy, Meat, Vegetables, Canned Goods) No GST No PST No HST Snack Foods (e.g., Chips, Pop) 5% 8% No (remains 13%) Qualifying Prepared Food and Beverages Sold for $4.00 or Less 5% No PST No (remains 5%) Restaurant Meals for More than $4.00 5% 8% No (remains 13%) Alcoholic Beverages 5% 10-12%

HST 13%[1]

What's Taxable Under the HST and What's Not…cont’d

Home Services

GST-taxable before July 1, 2010 PST-taxable before July 1,2010 Is there a change to the amount of tax payable under the HST?

Cable Television Services 5% 8% No (remains 13%) Cell Phone Services 5% 8% No (remains 13%) Municipal Water No GST No PST No HST Home Maintenance Equipment 5% 8% No (remains 13%) Home Phone Services 5% 8% No (remains 13%) Home Service Calls to Repair Free- Standing Appliances such as Stoves, Refrigerators, Washers, Dryers, and Televisions 5% 8% No (remains 13%) Home Insurance No GST 8% No (remains 8%) Electricity and Heating (e.g., Natural Gas/Oil for Home) 5% No PST Yes (changes to 13%) Internet Access Services 5% No PST Yes (changes to 13%) Home Service Calls by Electrician/Plumber/Carpenter to Maintain

• r Repair Furnace, Leaky Faucets,

Bathtub, Toilet, Electrical Wiring, etc. 5% No PST Yes (changes to 13%) Landscaping, Lawn-Care and Private Snow Removal 5% No PST Yes (changes to 13%)

What's Taxable Under the HST and What's Not…cont’d

Accommodation, Travel and Passenger Transportation Services

GST-taxable before July 1, 2010 PST-taxable before July 1,2010 Is there a change to the amount of tax payable under the HST?

Luggage, Briefcases, Bags, etc. 5% 8% No (remains 13%) Municipal Public Transit No GST No PST No HST GO Transit No GST No PST No HST

Air travel originating in Ontario and terminating in the U.S.[2]

5% No PST No (remains 5%)

Air travel originating in Ontario and terminating

• utside of Canada and the U.S.[3]

No GST No PST No HST Rail, boat and bus travel originating in Ontario and terminating outside of Canada No GST No RST No HST Hotel Rooms 5% 5% Yes (changes to 13%) Taxis 5% No PST Yes (changes to 13%) Campsites 5% No PST Yes (changes to 13%) Domestic Air, Rail and Bus Travel

• riginating in Ontario

5% No PST Yes (changes to 13%)

What's Taxable Under the HST and What's Not…cont’d

Motorized Vehicles

GST-taxable before July 1, 2010 PST-taxable before July 1,2010 Is there a change to the amount

• f tax payable under the HST?

Vehicle Parts 5% 8% No (remains 13%) Short-Term Auto Rentals 5% 8% No (remains 13%) Lease of a Vehicle 5% 8% No (remains 13%) Child Car Seats and Booster Seats 5% No PST No (remains 5%) Auto Insurance No GST No PST No HST Labour Charges to Repair Vehicle 5% 8% No (remains 13%) Oil Change 5% 8% No (remains 13%) Tires 5% 8% No (remains 13%) Window Repair 5% 8% No (remains 13%) Purchase of Vehicle from Dealer 5% 8% No (remains 13%) Boats 5% 8% No (remains 13%) Snowmobiles 5% 8% No (remains 13%) Recreational Vehicles 5% 8% No (remains 13%) Private Resale of Car (including Registration) No GST 8%

Yes[4] (changes to 13%)

Gasoline/Diesel 5% No PST Yes (changes to 13%)

What's Taxable Under the HST and What's Not…cont’d

Professional and Personal Services

GST-taxable before July 1, 2010 PST-taxable before July 1,2010 Is there a change to the amount

• f tax payable under the HST?

Child Care Services No GST No PST No HST Legal Aid No GST No PST No HST Coffins and Urns Purchased Separately from a Package of Funeral Services 5% 8% No (remains 13%) Fitness Trainer 5% No PST Yes (changes to 13%) Hair Stylist/Barber 5% No PST Yes (changes to 13%) Esthetician Services (e.g. Manicures, Pedicures, Facials) 5% No PST Yes (changes to 13%) Funeral Services 5% No PST Yes (changes to 13%) Legal Fees 5% No PST Yes (changes to 13%)

HARMONIZED SALES TAX - Conclusion

• No affect on Revenue-

since GST rules apply

• Taxable expenses 6.56% decrease
• Non-taxable expenses 1.44% increase
• 1.44% increase applies to services and energy costs that were

previously PST exempt

• Slight changes to OHRS account description not the account

numbers

MH LHIN Strategic Investments: Aging at Home Update

Narendra Shah

Aging At Home Peer Exchange Forum May 10-11, 2010 MH LHIN

I. Reduce ALC days and LOS in hospitals II. Reduce demand (wait list) for LTC homes III. Reduce unnecessary ER visits

Mississauga Halton LHIN’s Strategic Approach to A@ H

Strategic Objectives:

I. Invest in Seniors with Complex Needs (usually 75+ age) in the community II. Invest in LTC homes to reduce ER/hospitalization of 4,000+ residents; and, increase LTC homes capacity to care for “higher need” seniors III. Use proven common set of assessment/eligibility tools (RAI family) across all sectors-home care, SDL, ADP, LTC and CCC to ensure right care, right setting, at the right time and right cost

How?

Acute Care

FY 07/08 FY 08/09 FY 09/10

(1)

%Change to 09/10

FY 07/08 FY08/09

Total Days 354,055 372,563 355,182 0.3%

• 4.7%

Total Pts 60,864 61,408 63,077 Avg LOS 5.82 6.07 5.63

• 3.2%
• 7.2%

Total ALC Days 35,844 47,650 32,918

• 8.2%
• 30.9%

Total ALC Pts 2,174 2,432 2,623 20.6% 7.8% Avg ALC LOS 16.49 19.59 12.55 %ALC 10.10% 12.80% 9.27%

• 8.2%
• 27.6%

(1) Q4 09/10 Projection using average Q4 proportion of 07/08 and 08/09 and Q3 YTD year-over-year average growth

MH LHIN Trend in ALC Day & Patients 2008-09-2010

3.53% absolute point reduction in ALC Days in 09/10

Pre-A@H Pre-A@H Impact of A@H Impact of A@H

3.6% 2.7%

• 23.9%
• 35.9%

Results Growth

Despite growth we have good results

Source: MH LHIN Daily ALC Census

151 67

6 Month Average:

• High Risk Seniors (MAPLe

3+)

• Clients taken from Hospitals,

Community and LTC Sectors

• Integral part of Joint Discharge

Process in hospitals and CCAC

2010/11

Additional Performance Requirements

Reform of SH to Supports for Daily Living

Focus on Reducing LTC Needs 24/7; Integrated Approach LHIN-wide Mobile Capacity Extensive Interaction with Hospitals and CCAC

$24.7M

New Clients 740

• Expand to Support difficult cases in

Hospitals and LTCHs;

• Clients assisted to avoid

ER/Hospiital

• Reduce ALC

ABI

Significant outreach to Hospitals and LTCHs $4.9M

• LHIN-wide Approach

Integrated Transportation

$1.9M

• Reduce LTC/ER Demand
• Use of Care Giver Stress (CGS)

Tool

Enhanced Respite Care

Block of Time

$3.9M

270 Integrated Home Making/Maintenance$2.2M

• All referrals from CCAC
• Higher Needs –

MAPLe 3

• Reduce LTC Demand

Adult Day Services

Support more “at risk” Seniors

$8.4M

385

Stand-alone Transportation Services $1.5M

Transformation of CSS Sector to Focus on Frail Elderly Transformation of CSS Sector to Focus on Frail Elderly to Stay at Home Safely to Stay at Home Safely

Pre-LHIN 2007/08

CSS Performance Requirements

Objective: Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)

$34.3M

• # Clients
• Balanced

Budget

• Client

Satisfaction

Supportive Housing

Most clients MAPLe 1,2s No 24/7 support Limited integration with hospitals $13.5M

Adult Day Services

Most clients MAPLe 1,2s

$5.5M ABI

Residential with Community Outreach $3.6M

Respite Care

Day-To-Day Caregiver Relief

$2.9M

Home Making/Maintenance

$1.0M

Other CSS

$6.3M

Other CSS

$7.7M

$53.7M

Support Higher Need “At Risk” Seniors Support Higher Need “At Risk” Seniors SILO  Integrated Approach SILO  Integrated Approach

Increase of $19.4M

• Free Existing Hospital Capacity
• Right Placements in LTC Sector by CCAC

99

Convalescent Care Program Post Inn Convalescent Care Program Post Inn

4,100 Beds @ 27 homes

Convalescent Care Program Post Inn Convalescent Care Program Post Inn Restore Program ‐ MLC Restore Program ‐ MLC 220 bed LTC Facility at Trillium West Toronto – 5.4% 

4,100 Beds @ 27 homes

Dialysis at 2 homes Dialysis at 2 homes Behavioural Unit – Sheridan Villa Behavioural Unit – Sheridan Villa

Psycho Geriatrc Outreach ABI Outreach NP Program

Quality Improvement with OHQC – 8 Homes

Specialization Quality Improvement

MH LHIN MH LHIN – – Transformation of LTC Sector Transformation of LTC Sector

Pre‐LHIN LHIN – February 2010

Integration (CSS & CMHA with LTC Sector) Integration (with Hospitals & CCAC)

100

Impact of A @ H Initiatives on MH LHIN Allocation By Sector (in Millions)

LHIN Allocation: 2007/08 (Actual) Pre-Aging @ Home 2009/10 Note 1 (Q4 Forecast) % Change Hospitals $713,531.3 $769,863.9 7.89% Long Term Care Homes 146,611.2 162,921.5 11.12% CCAC 101,685.3 116,037.9 14.11% Community Support Services 17,162.0 22,274.2 29.79% Supportive Housing & SDL 13,499.1 21,629.4 60.23% Community Mental Health 21,436.2 23,966.6 11.80% Addictions Program 3,825.6 4,253.1 11.17% ABI 3,623.6 4,892.3 35.01% Total 1,021,374.3 1,125,838.9 10.2%

Note 1

09/10 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec. 2009.

Chronic Disease s CHF/ COPD Chronic Disease s CHF/ COPD Hom e Care by CCAC Hom e Care by CCAC Adult Day Program s Adult Day Program s Specialize d Geriatric Outreach Specialize d Geriatric Outreach Home Help/ Maint. Home Makin g Home Help/ Maint. Home Makin g 24/7 Crisis Response to Mental Health & Addictio n 24/7 Crisis Response to Mental Health & Addictio n

Objectives LOS ALC Admission Avoidance

Objectives ER Use  Treatment Time

ER

Objectives  Demand  Right Persons 27 Homes 4,100 Beds

LTCH

CCAC Enhanced CCAC Enhanced Transitional Beds in Hospitals – 41 beds Transitional Beds in Hospitals – 41 beds MLC Restore ‐ 26 beds MLC Restore ‐ 26 beds ABI Outreach ABI Outreach

Capacity Enhancement in Home/Community

Transitional Capacity

CCAC CSS CMHA

SDL SDL

Continenc e Mgmt 75+ Continenc e Mgmt 75+ NP’s In LTC NP’s In LTC Geriatri c System Mgmt. 75+ Geriatri c System Mgmt. 75+ Enhance d Respite Enhance d Respite Psycho‐ geriatric Outreac h Psycho‐ geriatric Outreac h Complex Continuing Care Reform – 300+ beds Complex Continuing Care Reform – 300+ beds Regional Behaviour Unit Regional Behaviour Unit

MH LHIN Aging at Home Strategic Approach MH LHIN Aging at Home Strategic Approach

Right Care, Right Place, Right Time

Convalescent Program Post Inn ‐20 beds Convalescent Program Post Inn ‐20 beds

Dementia & Alzheimer ’s Outreach & Day Programs Dementia & Alzheimer ’s Outreach & Day Programs Urgent Falls Progra m Urgent Falls Progra m

Transportation

Enhanced Palliative Enhanced Palliative Sheridan Villia Behavioural Unit ‐ 19 Sheridan Villia Behavioural Unit ‐ 19

SDL ER Avoidance

ERs Avoidance Strategies

24/7 Crisis Service For Mental Health & Addictions CDPM Mgmt Urgent Geriatric Clinic NPs LTC Homes

2009/10 2010/11

MH LHIN Aging at Home MH LHIN Aging at Home

Investments Implications on ER Improvement Investments Implications on ER Improvement

Right Care, Right Place, Right Time

Falls Clinic CCAC Follow up on all 75+ From ER Palliative End

• f Life

Capacity in Home Care

1,123 encounters 1523 ER visits averted 1046 Visits

8,000

Performance of MH LHIN’s Top Three Initiatives in Years 1& 2 which we will invest more in this Fiscal Year

Innovative and Best Practice Initiatives:

• Enhanced Home Care
• Supports in Daily Living
• Restore Program

MH CCAC Enhanced Services to Frail Seniors 2009-10

104

Home First Program – Hospital Referrals Stay at Home Program

WAH – LTC WAH – Enhanced

MAPLe Score 09/10 Actual # Clients (March 31, 2010) 1 2 3 2 5 3 3 57 63 29 4 107 124 126 5 70 51 58 TOTAL Clients 241 244 213 Client Avg MAPLe (per above) 3.99 3.89 4.14 Client Avg/Mon. PSW hours Before 60 Days 130 After 60 Days 108 Before 30 Days 88.2 After 30 Days 85.7 Before 30 Days 83.7 After 30 Days 85.6 Client Avg LOS on Enhanced Service 2.7 months 5.1 months 8.3 months

73.4% 71.7% 86.4%

Source: MH CCAC, March 31, 2010

105

Major Transformation of “Supportive Housing” to Supports for Daily Living – ‘Hub & Spoke’ 2008/09/10 Results

(1) MAPLe

Pre‐SDL Client Group SDL Client Group 1 45 13 2 28 33 3 104 189 4 64 163 5 22 84 Avg Score 2.96 3.56 TOTAL Clients 263 482

Age

Pre‐SDL Client Group SDL Client Group <65 4 9 65‐74 27 99 75‐84 90 213 85+ 207 256 Avg Age 85.9 80.0 TOTAL Clients 328 577

81.3% 51.2%

Referrals

FY 08/09 Q1 09/10 Q2 09/10 Q3 09/10 Q4 09/10 TOTAL

Hospital 11 5 23 81 120 Non‐Hospital Restore 2 2 4 CCAC 88 30 83 80 76 357 Other 1 13 11 25 Sub‐total 88 31 85 93 89 386

TOTAL 88 42 90 116 170 506

(1) As per available data

In buildings with high concentration of seniors

106

Supports for Daily Living – Mobile 2008/09/10 Results

MAPLe

SDL Client Group 1 2 1 3 38 4 45 5 15 Avg Score 3.75 TOTAL Clients 99

Age

SDL Client Group <65 2 65‐74 24 75‐84 34 85+ 39 Avg Age NA TOTAL Clients 99

Referrals

Q1 09/10 Q2 09/10 Q3 09/10 Q4 09/10 TOTAL

Hospital 4 9 11 17 41 Non‐Hospital Restore 2 2 CCAC 5 25 14 7 51 Other 1 2 2 5 Sub‐total 6 25 16 11 58

TOTAL 10 34 27 28 99

60.6% 73.7% Nimble & Timely response

112

“More health care is not always better for individuals or for populations”

Next Steps

• Ministry expects LHINs to reallocate funds where initiatives are

not meeting outcomes or to support other initiatives that have higher success

• We will review Year 2 results in the next 2 months and where

investments are not meting performance objectives, adjustments and changes will be considered

• Finalize Year 3 funding-all one-time subject to performance

expectations

• Province-wide evaluation of A @ H by ICES (Ministry sanctioned)
• LHIN evaluation of SDL
• MH LHIN Knowledge Exchange Forum for all A @ H investments
• September 29, 2010—HOLD THIS IMPORTANT DATE

Integration Feedback

Angela Jacobs

Remember the Question?

Given the current economic constraints that we expect to see over the next couple of years, what do you see as being the best integration

• pportunities to sustain or improve the system?

Feedback Summary

1. Back Office Integration a) Procurement of goods (consumables) b) IT costs/planning/software c) Sharing “experts” – HR/Finance/bookeeping/legal 2. Education and Training a) Sharing educational and skill enhancement

• pportunities

b) Training of the system e.g. discharge planners/social workers/CCAC regarding community services 3. Transportation 4. Electronic Connections

Summary

1. Back Office Integration

• MH LHIN has a Procurement Committee chaired by

John Simpson, Senior Account Executive, Shared Services West

• Shared Services West provides procurement services

to its four hospital members and one non-member hospital.

• Investigating opportunities –

whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts.

• Everyone participated in the SSW survey.

Summary

1. Education and Training example

• MH LHIN MH&A HSPs through SIGMHA (System

Integration Group for Mental Health and Addiction) established an Education and Training Task Team

• Focused on building a sustainable Education Program
• Surveyed all HSPs regarding learning needs
• Held 6 workshops –

attendees included: service providers, front line staff, clients and families, intake staff etc.

• Self-sustaining in terms of funding

Summary

• Now has transitioned into The Education Implementation Work

Group to lead the development of a sustainable education and training program for service providers, clients, families, and the community at large within the Mississauga Halton LHIN.

• Purpose is: The Education Implementation Group will.

To establish a LHIN-wide education and training program focused on SIGMHA’s strategic directions and the results of on-going learning needs surveys and other identified training needs.

• Possible new workshops:
• Transitional Aged Youth
• Diversity
• Community Workshops for Clients and Families
• Concurrent Disorder Training

Questions?

• What are the initial steps the CSS sector

needs to do to move towards this kind of model for training?

• What are the training needs required by the

community sector as a whole (CSS + MH&A)?

• What are the initial steps needed to organize

this community training?

Canadian Red Cross Update

Valerie Cook

COMMENTS / QUESTIONS?