Health Capital Technical Topics MOHLTC Orientation to the Community Health Capital Programs Policy Operational Framework – Part II – Module 2 Thank you for joining us today for the second of 2 education sessions on the Operational Framework of the Community Health Capital Programs Policy, otherwise known as the CHCP policy

Agenda In Module 2 we will continue with the Blue River CHC example as the CHC begins Stage 2 Business Case planning

Learning Objectives At the end of Module 2 participants will understand: The purpose and outcomes of the Stage 2 Project Planning meeting How to complete the following worksheets: BC_1_Programs and Services BC_2_Detailed FTE Data BC_3_Care Team Model The Checkpoint II activities required for the Endorsing Organization and ministry in finalizing the end-state program and service composition of the CHC’s service model

Project Planning Meeting: Ministry Funded Projects Once a Planning Grant approval has been provided the ministry will: Organize a project planning meeting with the Lead, Partner and Endorsing Organizations Outline the worksheets that will require completion in the Business Case Customize and return the CHCP Toolkit to the Lead Organization for completion of the BC_1_Programs & Services worksheet in the Business Case This will be the only Business Case worksheet visible to the Lead Organization – all others will be hidden

Project Planning Meeting: Own Funds Projects Once approval to proceed has been provided the ministry will: Organize a project planning meeting with the Lead, Partner and Endorsing Organizations Outline the steps that will required for technical review of the project and any additional approval points If the Lead or Endorsing Organization requests a space calculation review, the Toolkit will be returned to the Lead Organization for completion the appropriate worksheets Where this review is requested, all worksheets required for completion will be enabled

The Part II: Business Case Worksheet This worksheet provides a summary view of all potential steps for completion of the business case

The Part II: Business Case Worksheet The Business Case worksheet displays key information once individual business case worksheets are completed: Below are listed the information that will be seen on this worksheet once all planning steps in the Stage 2 Business Case are complete Relevant Worksheet Information Displayed Outcome of Checkpoint 2 Approval of P&S Composition/Space Eligibility Outcome of Step 4.1: Examination Room Calculator Numbers of examination rooms at 100% to 60% utilization Outcome of Step 6: Space Requests Amount of space approved and distribution for cost share Outcome of Checkpoint 3 Approval of Space Requests Outcome of Step 7: Site Search Site selected Outcome of Step 8: Cost Estimate Summary of Project Total Estimated Costs Outcome of Checkpoint 5 Ministry Review of Business Case – Decision per Implementation Grant recommendation

Completing BC_1 Programs & Services Worksheet The Blue River CHC obtains a copy of the CHCP Toolkit from the LHIN The only worksheet that they will see in the workbook is the Application Form. Blue Water CHC assigns a staff member to work with the staff to complete the form.

BC_1_Programs & Services Worksheet

Completing BC_1_Programs & Services Worksheet There are 18 information fields for the Lead Organization to complete for every program or service that is proposed to be in the end state service model composition Name of Organization Providing Program/Service Name of Organization administrating Program/Service Lead or Partner Name of Program or Service Program Type Service Type Existing or New Program/ Service Description of Program/Service Population Served by Program/Service Endorsing Organization Relationship of Endorsing Organization to MOHLTC Does EO provide operational funding for program? % of the program's operating budget Other Source(s) of operational funding for the program % of other source of operating budget

BC_1_Programs & Services Worksheet Example In this view the Lead Organization describes 3 of the programs that will operate in the end state service model Some of the first 9 fields are free text while others provide drop down options for selection These first 9 fields provides basic information for each program/service Who provides and/or administrates the program/service The name of the program and services it provides Is this an existing or new program/service Description of the populations it serves

BC_1_Programs & Services Worksheet Example The next 9 fields describe sources of funding and whether each program is requesting ministry funded space The section is used by the ministry to determine space funding eligibility under the criteria described in the CHCP policy These fields provides for each program/service Describe operational funding sources and proportion of each source Request ministry funded space Where requesting ministry funded space: Identify staffing composition Describe financial commitment to staff funding and proportion of operational building cost funding

Checkpoint II: Endorsing Organization and Ministry Reviews of Program and Services Once the Lead Organization completes the BC_1_Programs & Services Worksheet, the Toolkit Workbook is emailed to the Endorsing Organization The Endorsing Organization will review and decide whether to confirms/endorse the inclusion of all or some of the listed programs and services in the end-state service provision model

BC_1_Programs & Services Worksheet: Endorsing Organization Review At the bottom of the worksheet are sections for the Endorsing Organization and the Ministry to document the review In this section the Endorsing Organization documents Date of the review Who did the review If there are operation cost increases know or anticipated how they will be managed Sign-off on the review

Checkpoint II: Endorsing Organization and Ministry Reviews of Program and Services The Toolkit workbook will then be emailed to the ministry The ministry will review and determine space funding eligibility as defined by the criteria in the CHCP policy These decisions will determine the composition of the final end-state service model.

BC_1_Programs & Services Worksheet: Ministry Review In this section the Ministry documents Date of the review Who did the review Confirmation of completion of the space eligibility review Sign-off on the review Once the composition of the Program and Service Model is finalized, the Toolkit Workbook is returned to the Lead Organization to continue Business Case planning

Completing BC_2_Detailed FTE Data Worksheet The Blue River CHC obtains a copy of the CHCP Toolkit from the LHIN The only worksheet that they will see in the workbook is the Application Form. Blue Water CHC assigns a staff member to work with the staff to complete the form.

BC_2_Detailed FTE Data Worksheet

BC_2_Detailed FTE Data Worksheet Example (Columns C-E) Continuing the Blue River CHC example, this is what the first three columns (C to E) of the BC_2_Detailed FTE Data worksheet will look like when you first open the worksheet This information corresponds exactly to what is in Columns G, H and I of the finalized BC_1_Programs & Services worksheet

BC_2_Detailed FTE Data Worksheet Example (Columns C-E) – Expanding for all Program Staff The Lead Organization uses the “insert” rows function to add the number of additional rows necessary under each program to equal the number of full-time and part-time FTE’s that comprise the total FTEs for that program

BC_2_Detailed FTE Data Worksheet Example (Columns C-E) – Expanded for all Program Staff This view shows the first 4 programs with rows added to accommodate staff

BC_2_Detailed FTE Data Worksheet: Adding Staffing Types The next step in completing this worksheet is to add programs and staffing types that would not be captured in BC_1_Programs & Services and therefore not automatically populate this worksheet These would include Indirect Service Providers, Administrative Staff and Support Staff Column C is free text, Columns D & E provide drop-down options The example above shows four Administrative Staffing Types created

BC_2_Detailed FTE Data Worksheet Example (Columns C-E) – Expanding for all Program Staff – Final View Once all the rows are added, the worksheet would now show rows for staff for all the Programs listed (Lead & Partner Organizations) and Administrative & Support Staff

BC_2_Detailed FTE Data Worksheet Example (Columns F-N) In this view columns D & E are hidden to show only Column C and all remaining columns for completion (D to N) In the following slides we will walk through each of these sections for the first three programs Addiction Counselling Family Practice MD Family Practice NP

BC_2_Detailed FTE Data Worksheet Example (Columns F to I) In Column F (Staffing Type) the Lead Organization selects from a drop down list the most appropriate staffing type In columns G, H & I, information is provided on whether the staff is full-time, part-time, the amount of hours worked per week and the FTE equivalent for that staff From this level of detail it becomes evident that the 3 FTE MD positions are actually 4 staff persons The fourth NP position is added as it will exist in the end state model although there is no staff allocated to this row in the current staffing model

BC_2_Detailed FTE Data Worksheet Example (Columns J to L) In Columns J to L the Lead Organization describes the end-state service model composition In this example the LHIN has committed funding for 1 net new FTE NP in the end state model All other services anticipate to maintain the same FTE allocation and distribution between P/T and F/T staff This information is populated in this section

BC_2_Detailed FTE Data Worksheet Example (Columns M to N) The final two columns show whether the approved FTE staff positions were filled or vacant for a proportion of the current or previous fiscal year The percentage of the year that the position was filled is rounded to the nearest full percentage for the fiscal year (e.g. 4 months vacancy = 75% of the fiscal year filled)

BC_2_Detailed FTE Data Worksheet Complete This worksheet is completed when: There is a row for each full-time and part-time staff FTE position approved in the current and end-state staffing model organized within Programs & Services All information regarding hours of work, part-time vs full-time status is complete and accurate All information regarding the percentage of current and previous fiscal year the staff positions were occupied is complete and accurate Those projects that require Examination Rooms will proceed to BC_3_Care Team Model worksheet Those that do not will proceed to BC_6_Space Requests worksheet

Completing BC_3_Care Team Model Worksheet The Blue River CHC obtains a copy of the CHCP Toolkit from the LHIN The only worksheet that they will see in the workbook is the Application Form. Blue Water CHC assigns a staff member to work with the staff to complete the form.

BC_3_Care Team Model Worksheet Care Teams can be led by an MD or NP and consist of one lead and any other staff that engage/have encounters with a client/patient in an examination room during one visit Once the number of Care Teams are entered, the worksheet automatically provides a Care Team information box for each Care Team

BC_3_Care Team Model Worksheet: Initial Steps The first step is that the Lead Organization identifies the number of care teams in the service model and describes the Care Team composition In the CHC example there will be 4 MD led care teams and 4 NP led care teams in the end-state model Therefore there will be 8 Care Teams with some leads being full-time and some part-time In addition to the lead there will be a phlebotomist as a member of all care teams

BC_3_Care Team Model Worksheet: Number of Care Teams Once the number of Care Teams is entered the worksheet provides a Care Team “information box” for each Care Team In the CHC example there will be 4 MD led care teams and 4 NP led care teams in the end-state model Therefore there will be 8 Care Teams with some leads being full-time and some part-time

BC_3_Care Team Model Worksheet: Completing Care Team Information Window For each Care Team Give the team a unique name (usually name of lead MD or NP) Identify if the lead is an MD or NP Enter for the Care Team Hours of work per average day Average # days worked per week Average # weeks worked per year For each Care Team Member Enter: % of FTE per week dedicated to that team (e.g. full time 1.0 FTE Phlebotomist supports 4 teams = .25% FTE for this team) Average length of routine encounter Average length of complex encounter % of complex encounters

BC_3_Care Team Model Worksheet: Care Team Information Calculations Once these fields are complete the Care Team worksheet calculates the Average Visit Length and the Total Maximum Visit capacity for each Care Team

BC_3_Care Team Model Worksheet: Complete The worksheet is complete when Each MD or NP in the staffing model is assigned as a lead for a Care Team All additional Care Team staff are identified for each Care Team All data fields are completed for each Care Team The information from the worksheet in addition to data from the BC_4_Service Volume worksheet will be used to calculate the number of examination rooms required for Care Team use

Completion of Programs and Services and Staffing Model Information This brings us to the conclusion of Module 2 of the Orientation to the CHCP Operational Framework – Part II In Module 3 we will continue with the Blue River CHC example as they: Document Service Volumes Model Care Team Scheduling Define Space Needs