1. Long Term Care Access Centre Tara-Lee Procter Transition Manager – Long Term Care Access Centre / Community Housing Options

2. Continuum of Housing with Care/Support Options Community LivingFacility Living Independent Living Supportive Housing Companion Care Personal Care Homes Chronic Care Program Respite Care in PCH

3. Role of The Access Centre Determine eligibility for LTC services assess hospitalized clients ensure all options are explored manage panel review board Maintain waitlist Winnipeg LTC clients In the Community In Hospital In PCH waiting for preferred choice PCH clients from other RHA’s and other provinces Manage follow-up placement for all LTC clients

4. Respite Programs Respite Care involves a planned, short term admission to a personal care home primarily to provide a period of relief to care giving family members. Emergency Respite placement for clients requiring LTC placement who are not coping in the community but have not yet been paneled

5. Supportive Housing Service Package Care Housing

6. Companion Care Companion Care Providers take 1-2 seniors into their private homes to provide health support services Companion Care Clients can access similar services as would be received in a PCH

7. Personal Care Home Program  Facility-based living with professional care and supports (24 hour)  39 Personal Care Homes in Winnipeg.  Provides residence, health services and support to more than 5,700 people.

8. Chronic Care Program Chronic Care Program Provides care to persons who require long term institutionalization but do not require the resources of an acute rehabilitation hospital. Service includes 24 hour coverage by professional nursing staff, ongoing monitoring of chronic conditions and provision of a safe supervised environment.

9. Panel Review Board Consists of a physician with expertise in geriatrics and a WRHA Home Care Team Manager Function to review applications to determine eligibility and suitability for Long Term Care placement Ensure alternate options are explored Ensure care needs are manageable in Long Term Care Panel may approve, defer or reject applications as appropriate

10. Access to Personal Care Home from the Community  Application for Long Term Care completed by Home Care Case Coordinator (if client is not known to Home Care – Central Intake: 940-2655) Includes: Assessment of care needs by Case Coordinator Assessment by family physician  Assessment is presented at the Panel Review Board

11. Access to Personal Care Home from the Hospital  Client, family & hospital care team request assessment for Long Term Care placement from the Hospital  Referral is made to the LTCAC Access Coordinator  Assessment is completed for Long Term Care in collaboration with the hospital care team  Assessment presented at the Panel Review Board

12. Waitlist Management The Long Term Care Access Centre manages all applications for placement in: -Supportive Housing -Companion Care -Respite -Personal Care Home -Chronic Care

13. Personal Care Home Choices Applicants choose one Personal Care Home as their preferred choice. Clients being transferred from hospital to Long Term Care will be expected to move to an available bed at an alternate choice facility (based on vacancies) Clients who are waiting for placement from the community and are unable to manage may also move to an available bed to await the preferred choice facility

14. Choosing a Personal Care Home Some items to consider when choosing a PCH include: Location Personal Care Home’s Mission and Resident’s Bill of Rights Availability of a spiritual program Cultural, language and religious considerations Specialty units Smoking policy Pet policies Safety and security The WRHA PCH Program has further information at the following link: http://www.wrha.mb.ca/ltc/pch/index.php

15. Access to Personal Care Home from the Community  Application for Supportive Housing completed by Home Care Case Coordinator (if client is not known to Home Care – Central Intake: 940-2655) Includes: Assessment of care needs by Case Coordinator Assessment by family physician  Application is Reviewed by the Community Housing Coordinator for approval

16. Access to Supportive Housing from the Hospital  Client, family & hospital care team request assessment for Supportive Housing placement from the Hospital  Referral is made to the LTCAC Access Coordinator  Assessment is completed for Supportive Housing in collaboration with the hospital care team  The Application is reviewed by the Community Housing Coordinator for approval  Assessment presented at the Panel Review Board  The client may be placed in an alternate PCH to await Supportive Housing choice

17. Appeals Process  Appeals for decisions related to Personal Care Home paneling or Supportive Housing approval may be made to the Transition Manager LTCAC/Community Housing Options

18. Long Term Care Strategy Plan to balance services and resources within Long Term Care (LTC) sector “Aging in Place” Creation of affordable community housing with support options Improve quality of Personal Care Homes (PCH) environments Partnerships ( Winnipeg Regional Health Authority, Manitoba Health, Department of Family Services and Housing, other stakeholders)

19. Long Term Care Strategy Components Four Models: Support Services to Seniors in Group Living (SSGL) Supportive Housing Specialized Supports Personal Care Home

20. Support Services to Seniors in Group Living (SSGL) Target Population Seniors in existing community congregate settings. Do not require 24-hour support and supervision Model Enhanced support services Health promotion focus

21. Supportive Housing Target Population Primarily cognitively impaired, frail elderly Require 24-hour support and supervision Model Community, congregate setting Personal support/supervision (24/7) Secure environment WRHA funds care component Individual pays rent and service package (*Affordability key issue)

22. Supportive Housing Supportive Housing Facilities: Lions Supportive Housing32 spaces Arlington House20 spaces Heritage House28 spaces Rosewood Village144 spaces Residence Despins48 spaces Existing Spaces 272 Spaces New Spaces 240 Spaces TOTAL 512 Spaces

23. New Supportive Housing Sites: Irene Baron Eden Centre (48 spaces) January 2008 Harmony Court (96 spaces) June 2008 Riverside Lions (48 spaces) Opened October 2008 Chez Nous (24 spaces) Opening November 2008 875 Elizabeth Road (24 spaces) Opening Feb. 2009 Supportive Housing

24. Future Anticipated Supportive Housing Sites: St. Michael’s Ukrainian Catholic Church – 48 spaces. Construction anticipated in 2009 Villa Cabrini - Potential of 12 spaces Lindenwood Manor – Potential of 24 spaces Supportive Housing

25. Specialized Supports Housing for Assisted Living (HAL) – 340 Princess  Young disabled persons  Phase 1 - complete (7 spaces filled)  Phase 2 – additional 5 spaces Transitional Living and Specialized Supports  Individualized service plans implemented Ventilator Dependent Individuals  8 spaces (1010 Sinclair) Behavioral Spaces (Challenging Behaviors)  12 spaces (sponsor not yet identified) Acquired Brain Injury (ABI)  15 spaces to be developed PRIME (Program for Integrated Managed Care of the Elderly)  220 spaces within 2 sites -Deer Lodge Centre and Misericordia  DLC PRIME anticipated to open December 2008

26. Specialized Supports Target Population  Persons with complex health needs and/or challenging behaviors (e.g. young disabled, persons with acquired brain injuries (ABI), ventilator dependent persons). Model  Provides services for people who require specialized supports to live in community.  Site-specific and individualized service plans.

27. Personal Care Home Personal Care Home Beds  Reduce placement rate from 121/1000 > age 75 to 106/1000>age 75 by 2010  Improve quality of PCH environments  Reduce multi-bedded spaces by 2010  Changes completed and planned by Fall 2007:  March 06 - Closure of Ft. Garry Care Centre (64 PCH beds). Construction underway for 96 Supportive Housing spaces.  Foyer Valade – 39 beds opened/filled in Dec 06  Closure of 55 beds at DLC Interim PCH – October 2007  Closure of 24 MHC Interim Beds – October 2007  River Park Gardens – 80 beds opened October 2007  Sharon Home consolidation – September 2008  Aboriginal PCH - 80 Beds (Projected opening 2010).

28. Summary: What do we hope to accomplish?  More affordable, appropriate living environments for people  Reduced likelihood of people having to move several times  Shorter hospital stays which will increase bed availability in acute care (including emergency departments)  Appropriate number of PCH beds for those who really need placement  Knowledge that people are moving to a place that will meet their needs and support aging in place

29. Questions?