1. A Better Model for Self‐Directed Care – Keys to Success
HomeCare Ontario Summit April 2018

2. Topics Trends – world wide; provincially What is self directed care
Considerations and challenges
Keys to success

3. Learnings so far

4. Health care trends
Patient voice and role of the family/ primary caregiver
Contracting:
Focus on performance and outcomes
Change in who you will be contracting with
Changes in funding models
Sectors restructuring:
Smaller – out
Integrated service delivery models – in
New partnerships and alliances - in
Competition
Workforce education and retraining
Information transfer – electronic health records
Use of clinical pathways to drive change

5. Health care trends Prevention and earlier intervention
Focus on Seniors and chronic conditions
Driving investment towards better models of care
Integrating services to better meet peoples needs
Improving performance
Strengthening leadership and supporting front line innovation
Working across governments to address health and other priorities
Better linkages from primary care to institutional care to community based care

6. Jurisdictions are committing to “put patients first” and for individuals to have a greater say in who works with them to provide support and service.

7. Endless possibilities for models of patient care support
from coast to coast to coast…. Or
World wide

8. Self-Directed Care – What it is and what it is not

9. Self-Directed Care Also known as Often described as a voucher system
Self managed care
Bundles of care
Direct funding
Often described as a voucher system
government funds the patient/family for required care services which then allows that patient/family to make purchases from available care providers.

10. Emerging Ontario Definition
Family-Managed Home Care Program*- under which eligible clients or their decision-makers will receive funding to purchase home care or employ care providers.
*Adapted from the 2015 Patients First: A Roadmap to Strengthen Home and Community Care: self-directed care option, in which clients and their caregivers are given funds to hire their own provider or purchase services from a provider of their choice.

11. Self-Directed Care Is not: Could be
An answer to all that ails the health care system
A model that will exist completely outside the traditional health care system
A catalyst for integration and improved system coordination

12. Self Directed Care
What we know:
A new model for service delivery and funding - is it really?
Home care service providers have been supporting self directed care for decades
Many countries around the world are making it work
Starts with specific patient population groups
Individualized funding directed by families

13. People want to be supported in the home of their choice

14. Self Directed Care What we know:
Patients and families appear to want parts of it – BUT really want to know what’s going to be available
Staff thrive on being part of a single care team with a focus on one patient/family
Health care has finite resources:
Self Directed care may not be for everyone

15. Self Directed Care What we still need/want to know:
Family carers: training; payment– how will it work
Training for recipients of individualized funding (HR, Record Keeping, Health and Safety, contracts, etc.)
Integration with existing providers (primary care through to long term care)- how will this work seamlessly
Training for providers
Quality – how will it be measure, assured and who is accountable
Role out and timelines
What happens when self-directed care no longer works for a family
Is there still an opportunity for shaping the model(s)

17. Healthcare of New Zealand Story
Who we were:
7,000 staff supporting more than 18,000 people per day
Wide variety of Programs and Services
In all communities throughout the country
Privately owned
Publicly funded and privately supported program offerings
We did not want to be………

18. Bette and Doug’s Story

19. Keys to Success

20. Keys to Success Customer Service, customer service, customer service
Focus on what the patient/ family really want
Understand what success looks like from the patient/family perspective

21. Keys to Success Articulate the desired culture and lead by example
Resource the model(s) appropriately
Blend the model(s) into the system of healthcare in the province
Be nimble, quick and ready to fail fast

22. Discussion

23. Thank you Sandra Hanmer Hanmer Governance and Leadership Development