1. Voluntary Integration

2. Integration Internet Definition: In other words: merging or take-over?
formed into a whole or introduced into another entity
make into a whole or make part of a whole
the act of combining or adding parts to make a unified whole
(the process of fitting into a community)
In other words: merging or take-over?

3. Integration Continuum
Central LHIN’s Definition:
Collaboration:
A mutually beneficial well-defined relationship entered into by two or more organizations to achieve common goals. Collaboration is the process of various individuals, groups, or systems working together but at a significantly higher degree than through co-ordination or co-operation. Collaboration typically involves joint planning, shared resources and joint resource management.
Collaboration occurs through shared understanding of the issues, open communication, mutual trust and tolerance of differing points of view.
Reference: Governance Toolkit.

4. PACE’s Integration Continuum
Information Sharing with Common Goals
Coordination by Localized Services Working Together
Service Collaborations
Partnerships
Voluntary or Involuntary Merge/ Integration
Back-Office Efficiencies
Performance Measurement
Consumer & Staff Safety
Provincial Attendant Services Business Case
Staff Safety – Training
1993: Voluntary Integration Bathurst Prince Charles/AO
2007: Voluntary Integration McLeod House
2010: Voluntary Integration Arts Carousel
OAILSP
OCSA
OHA
Central LHIN CSS Network
Central LHIN Attendant Services Network (CLASN)
CLASN: Service coordination, best practices, waitlist management, common assessments
CCSSN: CBI Initiatives in HR, IT, Common Assessment Tools, MIS, Health Equity
Abuse Prevention: knowledge exchange, best practices, training
Unique Huntington’s Disease (HD) Program
Women’s Shelters
ABI Services
Post Secondary Education
AAC Support
Accreditation Canada 4

5. So, why listen to me?

6. Voluntary Integration/Merge
Arts Carousel
McLeod House
Bathurst/ Prince Charles
Year
2010
2007
1993
Services
Attendant Outreach (AO)
ABI Supportive Housing (SH)
SH and AO
Funding Transferred
$1.2 million
$170,000
$1.4 million
Response to:
Agency approached PACE
Response to an RFP
MOH or LHIN
Central LHIN
Program Consultant/ MOH-LTC
Clients
48 clients
6 clients
40 SH & AO clients
Staffing
Non-union staff
Staff applied for jobs
Undertook interview process
Conditional offers made
No staff moved over
Unionized with SEIU
All staff moved over
2nd union acquired
Finances
Controlled, tight, one-times provided
Neutral
Enhancements provided, moved $ around easily

7. Process Steps: Preliminary work
Support for the Integration Initiative (PACE and Arts)
Speak to LHIN
HSIP to LHIN outlining changes, “wins”, addressing issues, community engagement, changes to financials, answering questions, deliverables etc.
Formal Intent to Integrate Letter
Briefing Note to LHIN
Formal notice to Staff and Consumers
Transitioning services
Closing down

8. Voluntary Integration Timelines
June
2008
November 2008
March
2009
May
August 2009
September
October
PACE Board makes decision to move forward with Arts in Integration Initiative
Arts and PACE seek Central LHIN approval of Integration Initiative
PACE assumes Interim Management of Arts
PACE begins negotiating with union re: transition of Arts staff
Arts Board completes Organizational Gap Analysis and Environmental Scan
Arts identifies four potential Integration partners
Arts and PACE submit joint HSIP to Central LHIN
Arts chooses PACE as Agency of Choice for Integration Initiative
Arts and PACE announce their Intent to Integrate (pending Central LHIN approval)
Arts Board Retreat: unanimous decision to investigate Integration Opportunities 8

9. Voluntary Integration Timelines - continued
November
2009
December
January 2010
February 2010
March
2010
April
2.5 days orientation given to all new staff
PACE and Arts submits Joint Letter of Intent to Central LHIN
Arts Staff apply and are interviewed for employment with PACE
Conditional Letters of Employment made to majority of Arts Staff
90 Days Notice given to Arts Clients
PACE takes over funding and operational responsibilities from Arts
New staff begin working at PACE
Arts continues to operate with 4 staff who are working out their notice periods
All Arts clients assessed and new Service Agreements signed with PACE
Arts officially closes its doors and ceases operations
Central LHIN Board Supports Integration Initiative
Working Notice given to Arts staff 9

10. How did it start?
In 2008, Arts Board undertook an organizational review to identify gaps and challenges in the long-term viability of the organization
Gaps identified included:
Need for an enhanced continuum of services for clients
Lack of in-house competencies in the areas of financial management, human resources and quality improvement
Need to make significant investments in infrastructure to meet and manage Accreditation and MSAA requirements
led to Art’s making the decision to explore opportunities
to integrate its operations with another Central LHIN
organization providing the same or similar services

11. Meeting the Central LHIN’s Criteria
The proposed voluntary integration meets the CLHIN’s
criteria for voluntary integration:
Access: the proposal provides an opportunity to improve access to services and expand the continuum of services for Arts Carousel clients in the areas of community escorts, case management, referrals, and system navigation
Coordination: assessments being completed on a common tool improves interagency referral/coordination and increases the availability of programs and services to meet client needs
Quality: Arts’ clients will benefit from PACE’s investment in accreditation and the implementation of Community Support Services Ontario Health Care Reporting Standards (CSS OHRS) which has become standard practice across the province
Efficiency: Service Administration will benefit from PACE’s more robust infrastructure (finances, HR, admin, leadership)

12. Alignment with IHSP Consistent with the IHSP for Central LHIN:
Emergency Department/Alternative Level of Care (ALC) Priority:
Assists in supporting people in their homes longer and out of long-term care and acute care
Provides an opportunity to improve access to services and expand the continuum of services
Health Equity Priority:
Clients will be assessed using the standardized assessment form which will help improve interagency referral and coordination, and increase the availability of programs and services to meet client needs
Coordination of services by one organization provides better continuity in services, case management support, and improves access/referrals to the continuum of services

13. Deliverables (how to measure)
Transfer of funds will result in increased service delivery and PACE’s
infrastructure will support the expansion of services in a timely/efficient manner.
The following indicators will be monitored to determine the impact of the
integration activity:
Increased volume of Director Service Hours by 1,040 hours/year (MSAA)
Improved interagency referral and coordination (Rai-CHA through PACE’s Key Performance Indicators)
Improved client satisfaction of services delivered (client satisfaction surveys)
Reduced long-term care and acute care use by assisting clients to stay in their homes longer (client satisfaction surveys)
Improved access to services and expanded continuum of services for Arts clients (MSAA)

14. Emphasis on: What was the CLHIN most interested in?
Community engagement
How much more is going into front-line services?
Quality
Finances
Transparency
CLHIN goals (IHSP)

15. Lessons Learned
Timelines – control them! (decision, HSIP, letter of intent, approval, notice, etc)
Process was much longer than expected
Finances – unexpected expenses
Communications – how much is too much, when to send things out, confidentiality
Interim management – wearing 2 hats

16. Questions?