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

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

3. 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).

4. 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.

5. 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.

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

7. 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.

8. 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.

9. Guiding Principles Developing the HAPS materials
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.

10. 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.

11. Updates for 2017-18 HAPS Guidelines
Updates to the HAPS Guidelines include:
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

12. 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

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

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

15. Assumptions
HAPS
Hospitals will individually and locally determine reasonable planning assumptions for use in the completion of the 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.

16. 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

17. 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

18. Questions about the HAPS?
Please contact your local LHIN.