1. Presentation to CADA Ontario Home Respiratory Services Association September 18, 2014

2. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 2 Presentation Objectives ■ Provide an overview of the Ontario Home Respiratory Services Association (OHRSA) ■ Provide information on key initiatives supported by OHRSA 2

3. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 3 OHRSA ■ OHRSA was founded in 1985 to represent the collective interests of private sector home respiratory service providers in Ontario. ■ Mission: As the recognized voice of service providers, OHRSA promotes the highest standard of home respiratory care across the province of Ontario. ■ Our activities are focused on three groups:  Our members  Our clients  Our funders 3

4. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 4 Our Membership ■ OHRSA has 22 member firms – more than 90% of all providers serving Ontario. All are registered service providers with the Ministry of Health and Long-Term Care ■ They deliver home oxygen services to approximately 23,000 residents, mostly seniors with lung disease. ■ Delivered services, which are partially funded by ADP, include:  Home oxygen therapy – long term need or for palliative care.  Positive airway pressure therapy: treatment of obstructive sleep apnea.  Assistance to patients with complex respiratory conditions.  Aerosol therapy.

5. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 5 Our Membership ■ Our members:  have embraced voluntary accreditation in order to obtain independent corroboration of patient care standards.  have a strong record of delivering cost effective, quality home care services. ■ Key goals:  strengthen the ability of individuals with severely impaired lung function to live at home, avoid hospitalization, and effectively manage their care.  Strengthen the quality of services, improve access and utilization of health care resources, and provider accountability

6. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 6 Major Initiatives Three key areas: ■ Proposal to ADP for funding support for Short-Term Home Oxygen Therapy. ■ Advocacy for a provincial approach to measuring quality of home oxygen services and client satisfaction. ■ Partnership with the Ontario Lung Association and others on the development of a provincial Lung Health Strategy.

7. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 7 Short-Term Home Oxygen Program ■ OHRSA’s Proposal to ADP:  Provide funding assistance to individuals with an acute respiratory illness and who require home oxygen therapy on a short term basis to avoid hospitalization or facilitate early hospital discharge. ■ Background:  Current Home Oxygen Program: ■funding for chronic and palliative oxygen dependent Ontarians. ■No coverage for individuals with mild/moderate lung disease, and who require oxygen on a short term basis.  2005-07- ADP piloted a short-term home oxygen program. ■Independent evaluation: the program should reintroduced and expanded, 7

8. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 8 Short-Term Home Oxygen Program Rationale for our Proposal:  Significant evidence from Ontario’s pilot and expert studies of benefits to patients and improved utilization of health care resources:  Evaluation of 2005-07 pilot found evidence of improved quality of care, and lower healthcare costs (20%) length of hospital stay (37%).  Similar findings found in the expert literature.  Provincial/national agencies recommend community-based alternatives to reduce the high rates of hospitalization of individuals with chronic obstructive pulmonary disease (COPD).  Independent study identified that Ontario’s COPD healthcare costs can be significantly reduced by shifting care from hospitals to the home with home care support. 8

9. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 9 Measuring Quality and Client Satisfaction ■ Objective is to implement a province wide, independently administered client satisfaction survey and indicators to measure the quality and value of services and client satisfaction. ■ Collaborative approach with ADP: advice on quality indicators, measures and process. ■ Similar process in place in home care sector and other sectors – based on Health Quality Ontario’s strategic roadmap. ■ Key objectives for OHRSA:  Evidence-based approach to measure quality and value  Strengthen focus on quality, value and accountability  Achieve better outcomes, better client experience and better value for money  Greater transparency and public reporting to tax payers 9

10. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 10 Support for a Provincial Lung Health Strategy ■ Partnership with the Ontario Lung Association (OLA):  2011 OLA study: health and economic burden of lung disease are significant and will increase over time.  Advocacy for: ■A comprehensive lung health action plan to achieve immediate changes to the prevention and treatment of lung disease. ■Coordinated and integrated provincial approach. ■Chronic Obstructive Pulmonary Disease (COPD) - a key focus of the strategy.

11. Ontario Home Respiratory Services Association. Delivering Care. Enhancing Independence. 11 Questions? 11