Re-structuring Health Care Delivery in Ontario Michael Scarpitti - - PowerPoint PPT Presentation

Re-structuring Health Care Delivery in Ontario

Michael Scarpitti Lead, Health Systems Transformation CMHA Ontario

Provincial Government has had a focus on re-structuring the health care system since election in June 2018. Reform across government: Ernst & Young conducted line-by-line review of expenditures, report released in September 2018: https://news.ontario.ca/tbs/en/2018/09/line-by- line-review.html

Current Changes

• Dr. Reuben Devlin appointed as special advisor on health

care reform, leading the new “Premier’s Council on Improving Healthcare and Ending Hallway Medicine.” Premier’s Council’s First Report Outlining System Challenges: https://news.ontario.ca/ihehm/en/2019/01/premiers-council-

• n-improving-healthcare-and-ending-hallway-medicine-

releases-first-report.html Premier’s Council’s Second Report Providing Recommendations: https://news.ontario.ca/ihehm/en/2019/06/premiers-council-

• n-improving-healthcare-and-ending-hallway-medicine-

releases-second-report.html

Current Changes

Ministry restructuring internally and across the system:

• Reorganized Ministry of Health,
• Hon. Christine Elliott remains Minister of Health
• New Ministry of Long-Term Care,
• Hon. Merrilee Fullerton is new Minister
• New Associate Minister of Mental Health and

Addictions, Hon. Michael Tibollo

Current Changes

• Ontario Health Teams Division (OHTD)

established to provide leadership and oversight to facilitate the development and creation of OHTs

• Mental Health and Addictions Division (MHAD)

established to lead the development and implementation of Ontario’s Mental Health and Addictions Strategy

Current Changes

Bill 74 received Royal Assent on April 18, 2019. This legislation creates the Connecting Care Act which is the legislation that will govern the new system. It also amends the Ministry of Health and Long- Term Care Act to create an Indigenous Health Council and French Language Health Services Advisory Council. These previously existed through regulation.

Bill 74, The People’s Health Care Act, 2019

The core features of the reorganization which will be rolled out over a number of years are:

• Creation of Ontario Health that centralizes the

functions of 20 organizations and has 5 regional offices.

• The creation of Ontario Health Teams, called

Integrated Care Delivery Systems in the legislation, composed of HSPs that would receive funding from Ontario Health to deliver coordinated services.

Key Features of Reforms

Ontario Health is tasked with centralizing accountability and oversight for the health care system, including governance, streamlining clinical care, and reducing back office. Digital health opportunities and updated supply chain management included.

Ontario Health

Ontario Health - Mandate

Ontario Health is governed by a 15 member Board of Directors, chaired by Bill Hatanaka. The board will be appointed by Orders in Council and will serve 3-year terms. They will be able to serve a maximum of 6 years. https://news.ontario.ca/mohltc/en/2019/03/ontari

• -health-board-of-directors.html

Ontario Health - Governance

Ontario Health is embarking on a recruitment process for a permanent Chief Executive Officer (CEO). On April 24, 2019, Susan Fitzpatrick was named Interim CEO of Ontario Health. Susan Fitzpatrick most recently held the position

• f CEO at the Toronto Central Local Health

Integration Network, and was previously an Associate Deputy Minister at the Ministry of Health and Long-Term Care.

Ontario Health - Leadership

Agencies that are being collapsed into Ontario Health include:

• Cancer Care Ontario, Health Quality Ontario,

E-Health, Health Shared Services Ontario, Trillium Gift of Life, and Health Force Ontario Marketing and Recruitment Agency

• As well as the 14 Local Health Integration

Networks. Boards of these agencies, including LHIN Boards, have already been dissolved.

Ontario Health - Structure

The interim regional clustering of LHINs in Ontario Health are:

• West Region: Erie-St. Clair, South West,

Hamilton Niagara Haldimand Brant, Waterloo Wellington LHINs

• Central Region: Mississauga Halton, Central

West, Central, North Simcoe Muskoka LHINs

• Toronto Region: Toronto Central LHIN
• East Region: Central East, South East,

Champlain LHINs

• North Region: North West, North East LHINs

Ontario Health - Structure

Ontario Health has the integration powers

• utlined in the Local Health Services Integration

Act (LHSIA). Ontario Health can facilitate and negotiate integrations but gives the power to direct integrations to the Minister. Ontario Health has the power to integrate the health system by providing or changing funding, integrating organizations that are health service providers or Ontario Health Teams and integrating services.

Ontario Health - Integration Powers

Ontario Health will establish a new Mental Health and Addictions Centre of Excellence and will carry out the following activities:

• Put into operation the mental health and addictions

strategy;

• Develop clinical, quality and service standards for

mental health and addictions;

• Monitor metrics related to the performance of the

mental health and addictions system;

• Provide resources and support to health service

providers, integrated care delivery systems and others related to mental health and addictions; and

• Any other functions that the Minister may direct.

Ontario Health - MHA Focus

Ontario Health Team model of local integrated care delivery is being implemented, with the intent of having seamless coordinated care through a team of networked providers. Care providers are partnering to form Ontario Health Teams that are responsible for care delivery, funding and coordinating care across a geographic area. The province is currently referencing approximately 80.

Ontario Health Teams

Ontario Health Teams must include 3 of the following: (i) hospital services (ii) primary care services, (iii) mental health or addictions services (iv) home care or community services (v) long-term care home services (vi) palliative care services (vii) any other prescribed health care service or non- health service that supports the provision of health care services; and any prescribed conditions or requirements have been met.

Ontario Health Teams - Services

Upon review of the Self-Assessment Forms, the Ministry assigned applicants to one of three categories: 1. Proceed to Full Application: These teams have partners across the continuum of care. They are highly aligned with the model, have a high level of readiness and are well-positioned to complete the full application. 2. In Development: These teams have partners who represent a continuum of care, are committed to the model, and with a bit more work will be well positioned to complete the full application. 3. In Discovery: These health care providers support the model. They are encouraged to expand their partnerships and work with other local providers in alignment with the criteria outlined in the guidance document. A complete list of all applicants that have been designated as Proceed to Full Application and In Development can be found here: http://health.gov.on.ca/en/pro/programs/connectedcare/oht/teams.aspx

Ontario Health Team Applications - Status

• All Nations

Health Partners OHT

• Brampton,

Etobicoke and Area OHT

• Burlington OHT
• Cambridge

North Dumfries OHT

• Chatham-Kent

OHT

• Connected Care

Halton OHT

• Couchiching

OHT

• Durham OHT
• East Toronto

OHT

• Eastern York

Region and North Durham OHT

• Guelph and

Area OHT

• Hamilton OHT
• Hills of

Headwaters Collaborative OHT

• Huron Perth and

Area OHT

• Mississauga

OHT

• Muskoka and

Area OHT

• Near North

Health and Wellness OHT

• North Toronto

OHT

• North Western

Toronto OHT

• North York OHT
• Northumberland

OHT

• Ottawa OHT
• Peterborough

OHT

• Southlake

Community OHT

Visit the websites of the announced OHTs here.

Ontario Health Team Applications – Announced Teams

The Ministry will continue to accept, assess and evaluate groups as they demonstrate readiness to become designated as Ontario Health Teams. The following are important dates in the Ontario Health Team application timeline:

• Deadline for in-development progress reports - January 2020
• Next invitation for full application submissions - March 2020

Ontario Health Team Applications - Important Dates

The Ministry has released resources for providers completing an Ontario Health Team application:

• Self-Assessment Form and Full Application Form
• Ontario Health Teams: Guidance for Health Care Providers and Organizations
• Webinar on Ontario Health Teams and Guidance Document
• Webinar on Self-Assessment Process
• Jurisdictional Scan on Select Integrated Care Systems, a document which presents findings from the research

literature, grey literature, and relevant websites on topics pertaining to Integrated Care Systems (ICSs) around the world that integrate care across the full continuum of care and serve a large population over a wide geographical area.

• An essential reading list on Integrated Care Delivery Systems for providers and organizations.
• Ontario Health Teams: Digital Health Playbook which can be used by applicants to help understand how they

can build a digital health plan for Ontario Health Teams that supports the delivery of integrated care.

• Rapid-Improvement Support and Exchange (RISE) - an interactive website that provides access to resources,

experts and assistance for potential Ontario Health Teams. RISE is supported by the McMaster Health Forum (MHF) and the Ministry of Health (MOH). Community Health Ontario (CHO) has developed a 7-Part Webinar Learning Series on Building Collaboration Capacity for Ontario Health Teams. Those interested can view the webinars here.

Ontario Health Team Applications - Resources

Thank You

Questions?

mscarpitti@ontario.cmha.ca