Hospital Accountability Planning Submission (HAPS) Process Fiscal 2018/19 Presented in Fall 2017

Context Planning for 2018/19 The H-SAA 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 H-SAA Schedules. Both the HAPS forms and the guidelines have been refreshed. The HAPS and related Schedules will cover one fiscal year (FY 2018/19).

Context Planning for 2018/19 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 H-SAA 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 2018/19 Hospitals are currently engaged in developing budgets to guide operations for fiscal 2018/19 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 H- SAA.

Guiding Principles Developing the HAPS materials 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 H-SAA within the requisite timeline. Ensure alignment. All core HAPS/H-SAA materials (Guidelines, Forms and Schedules), should align with one another.

Updates for 2018-19 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 24, 2017. 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 February 2018.

Updates for 2018-19 HAPS Guidelines Updates to the HAPS Guidelines include: 2018-19 timelines for HAPS submission Updated section regarding HSFR Refined list of QBPs Added Stroke Endovascular Treatment Removed Acute Inpatient Neonatal Jaundice* * This is now factored into LHIN Global Allocation in the Revenue and Expense tab.

Updates for 2018-19 HAPS Guidelines Changes to Embedded Documents within HAPS Guidelines: Within Additional Input Form: In the Supplemental Input Form for Schedule A, under Wait Time Strategy Services, there will now be 2 separate columns. Base funding will continue to be indicated in one column, while Incremental Base funding will now be reflected in the second column. Within HAPS Narrative: Updated Sexual Assault and Domestic Violence Treatment Centre Annual Program Report form. Within HAPS narrative: a Section of Capital Planning is included. PLEASE USE the Narrative Template that provided along with the HSAA Memo in Oct, 2017.

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

Assumptions HAPS Hospitals will individually and locally determine reasonable planning assumptions for use in the completion of the 2018-19 HAPS. Use information currently available including assumptions for HBAM and Quality Based Procedures. The LHIN will review assumptions for reasonableness.