Hospital Accountability Planning Submission (HAPS) Process Fiscal 2017/18 Presented in Fall 2016

Agenda Context HSAA Organizational Structure Guiding Principles Updates for 2017-18 HAPS Submission Timelines HAPS Guidelines Projected Timelines for 2017-18 Planning for Key Variables Planning Environment Considerations Assumptions Appendix A: HSAA Planning & Schedules WG Membership Questions

Context Planning for 2017/18 The HSAA Template Agreement is envisioned to be a multi-year agreement established through consultative stakeholder meetings between the LHINs, hospitals, the OHA and MOHLTC. The Schedules content will be negotiated annually. Information collected through the Hospital Accountability Planning Submission (HAPS) and the Additional Input forms will be used to populate the HSAA Schedules. Both the HAPS forms and the guidelines have been refreshed. The HAPS and related draft Schedules will cover one fiscal year (FY 2017/18).

Context Planning for 2017/18 The government continues to implement Health System Funding Reform (HSFR), which supports system capacity planning and quality improvement through directly linking funding to patient outcomes. LHINs and the hospitals recognize that HSFR will impact the HSAA process. Hospital funding has become unique to each individual hospital with the roll out of the Health Based Allocation Model and Quality-Based Procedure Funding (QBP) and so “across the board” planning targets are no longer relevant or possible.

Context Planning for 2017/18 Hospitals are currently engaged in developing budgets to guide operations for fiscal 2017/18 as part of their organization’s fiduciary duty, and hospital services will continue to be provided to patients according to the hospital’s internal plan and based on the hospital’s best assumptions. There is great benefit for hospitals and LHINs to agree on performance expectations within a set of parameters that begins on day one of the fiscal year. The vehicle for this agreement is the HSAA.

HSAA Organizational Structure Creating an ownership framework Hospitals (OHA) HSAA Steering Committee HSAA Planning & Schedules Work Group SRI Reports Work Group HSAA Indicator LHINs

HSAA Organizational Structure Creating an ownership framework The HSAA Planning & Schedules Work Group is co-led by Jeff Kwan, Director, Financial Health & Accountability, North Simcoe Muskoka LHIN, and May Chang, Executive Vice President and Chief Administrative Officer, Markham Stouffville Hospital. The SRI Reports Work Group is led by Pete Crvenkovski, Director, Performance Quality and Knowledge Management, Erie St. Clair LHIN. Based on the HSAA Steering Committee’s planning assumptions, the core deliverables of the HSAA Planning & Schedules Work Group were to prepare draft schedules and planning submission documents and produce related education materials.

Guiding Principles Developing the HAPS materials The deliverables of the Planning & Schedules Work Group were set with the following guiding principles in mind: Practicality - Develop products that reflect our current reality and are easy to use/understand. Emphasis on local within the provincial context - For planning targets, performance indicator targets and other health system changes.

Guiding Principles Developing the HAPS materials 3. Partnership Approach - Hospitals and LHINs should liaise early and often in order to develop a mutually acceptable HSAA within the requisite timeline. Ensure alignment. All core HAPS/HSAA materials (Guidelines, Forms and Schedules), should align with one another. The Work Group will also strive for enhanced functionality whereby one form/schedule may be pre-populated by another where appropriate.

Updates for 2017-18 HAPS Submission Timelines Last year, the LHIN CEOs endorsed a standardized work plan to provide predictable dates for key deliverables for all future years. As such, the HAPS submission timeline was in November. Similarly, this year’s HAPS timeline will be November 21, 2016. The LHINs do not consider this submission to be final as changes usually occur post submission up to January through the LHIN review process. The final HAPS is approved by Hospital Boards in January 2017.

Updates for 2017-18 HAPS Guidelines Updates to the HAPS Guidelines include: 2017-18 timelines for HAPS submission Updated pan-LHIN strategic directions Refined list of QBPs Updated Service Delivery Change Form and Sexual Assault and Domestic Violence Treatment Centre Annual Program Report form within HAPS Narrative Similar to last year, a number of documents are embedded within the HAPS Guidelines, including the HAPS Narrative, Revenue Completion Guidelines, an Additional Input Form to capture supplemental details not captured in the HAPS, and instructions on the submission of supplemental forms

Projected Timelines for 2017-18 HAPS and HSAA Activity Time Frame HAPS Completion HAPS on SRI HAPS Narrative (submit as document through SRI) HAPS Additional Input (submit as document through SRI) Oct. 3/16 to Nov. 21/16 Recommended Dates for Local HSAA Schedules/Indicator Education Nov. 9/16 to Nov. 18/16 Local Indicators & Performance Targets to Hospitals Negotiated & Finalized Nov. 1/16 to Nov. 30/16 Performance Targets for Provincial Indicators Negotiated & Finalized Nov. 21/16 to Dec. 9/16 Hospital Boards approve HAPS Jan. 2/17 to Jan. 31/17 LHIN prepares the Hospital Agreements and Schedules & sends to Hospitals Jan. 16/17 to Feb. 1/17 Hospital Boards approve HSAA agreement and returned signed copies to LHIN Feb. 1/17 to Mar. 31/17

Planning for Key Variables HAPS Key variables to consider when completing the HAPS include: Mitigation HBAM QBPs

HAPS Planning Environment Considerations Breaking the cycle of Rework The Mystery of Funding Scenario Planning It’s just a “Plan” Timelines

Assumptions HAPS Hospitals will individually and locally determine reasonable planning assumptions for use in the completion of the 2017-18 HAPS. Use information currently available including assumptions for HBAM and Quality Based Procedures. The LHIN will review assumptions for reasonableness. In some LHINs, the LHIN and hospitals may collectively agree on a common set of assumptions.

Appendix A: HSAA Planning & Schedules Work Group Membership Sector Organization Individual, Title LHIN NSM LHIN Jeff Kwan, Director, Financial Health & Accountability (Co-Chair) Hospital Markham Stouffville Hospital May Chang, Executive Vice President and Chief Administrative Officer (Co-Chair) Collingwood General & Marine Hospital Michael Lacroix, Vice President, Corporate Services & CFO North York General Hospital Deepak Sharma, Director, Decision Support St Michael’s Hospital Tomi Nieminen, Director, Decision Support Services Trillium Health Partners Carol Vinette-Hancharyk, Director, Financial Strategy & Deputy Chief Financial Officer MOHLTC Ministry of Health and Long-Term Care Maria van Dyk, Team Lead OHA Ontario Hospital Association Imtiaz Daniel, Director, Financial Analytics and System Performance

Appendix A: HSAA Planning & Schedules Work Group Membership (cont’d) Sector Organization Individual, Title LHIN C LHIN Jennifer Chiarcossi, Senior Business Analyst Kelvin Luk, Business Analyst SW LHIN Scott Chambers, Team Lead MH LHIN Carrie Parkinson, Senior Lead Andrew Wahab, Senior Lead of Funding and Allocation NE LHIN Marc Demers, Controller / Corporate Services Manager NW LHIN Kevin Holder, Senior Consultant TC LHIN Erin Scholl, Senior Consultant

Questions about the HAPS? Please contact your local LHIN.