1. Engaging with Local Health Integration Networks Jill Tettmann, CEO North Simcoe Muskoka LHIN Chantale LeClerc, CEO Champlain LHIN Family Service Ontario Conference 2015 “Moving Forward Together” May 5 th, 2015 1

2. Overview of Session What is a LHIN Single-Session Intervention in the Champlain and NSM LHINs Working with your local LHIN 2

3. Local Health Integration Networks Regionalization of Health Care in Ontario 3

4. What is a LHIN? Devolving health care decision-making to the local level In 2005 Ontario moved to a regionalized healthcare model, recognizing that a community’s health needs are best understood by people who live there LHINs are not-for-profit crown agencies responsible for planning, integrating and funding local health services in 14 geographic areas of the province LHINs are now accountable to the Ministry of Health and Long Term Care for over $23B in annual funding Unlike other provinces in Canada, local health service provider boards have been maintained LHINs replace the 16 District Health Councils and 7 Regional Offices of the Ministry of Health 4

5. Establishes 14 LHINs and defines their structure, powers and board composition Outlines LHINs’ responsibilities for planning, funding and community engagement Specifies the LHINs’ integration powers including: Providing a definition of integration and describes types of integration Outlining the shared responsibility of LHINs and health service providers to identify opportunities to integrate the health system Local Health System Integration Act (2006) Creating the Legislative Framework to for a more Integrated System 5

6. LHIN Geographic Regions LHIN Regions: 1. Erie St. Clair 2. South Ouest 3. Waterloo Wellington 4. Hamilton Niagara Haldimand Brant 5. Central West 6. Mississauga Halton 7. Toronto Centre 8. Centre 9. Central East 10. South East 11. Champlain 12. North Simcoe Muskoka 13.North East 14. North Ouest 6

7. LHIN Mandate Planning Community Engagement Financing and Allocations Accountability and Performance Management Integration and Coordination 7

8. LHIN Funded Health Service Providers Hospitals Community Care Access Centres Community Support Services Mental Health and Addictions Services Community Health Centres Long Term Care Homes 8

9. Programs Not Funded by LHINs Ontario Health Insurance Program (OHIP), including physician fees Clinics, ambulance services and laboratories Provincial programs such as Cancer Care Ontario and the Ontario Renal Network Capital for hospital and community investments Provincial drug programs Most primary care providers, including Family Health Teams and other inter-professional teams 9

10. 3 Levels of the Ontario Health System LHINs role in the provincial accountability framework Ministry of Health & Long Term Care LHINs Health Service Providers Sets provincial standards, policy, provincial direction and priorities Holds LHINs accountable through performance agreements and MOU Retains responsibility for funding models & LHIN funding envelope Plan and manage the local system, aligned to provincial priorities Hold local providers accountable through Service Accountability Agreements, performance management and monitoring, funding Provide leadership for local integration 10 Manage own operation and plan within the LHIN context

11. Single-Session Interventions 11

12. The Champlain LHIN Easternmost region 18,000 square kilometers 1.2 M people 20% francophone 3% Aboriginal 18% immigrant 20% of Champlain residents live in a rural community Large border with province of Québec 176 accountability agreements for health services 12

13. A network of common walk-in counseling clinics have been established through an existing funding relationship between the LHIN and a Family Service Agency Walk-in counseling is for individuals who, due to the perceived urgency of the situation, would otherwise consider a visit to the Emergency Department Evaluative results from other jurisdictions suggest that about 20% of clients feel they were able to avoid an ED visit as a result of the counseling session Walk-in single session counseling as an emergency department diversion initiative

14. Part-time clinics are available in Deep River & Cornwall Part time clinics are available in French and English in Ottawa staggered across every day of the week Part time clinics are available in immigrant community agencies in Arabic, Cantonese, Mandarin and Somali

15. Preliminary results The most common presenting problems are depression, anxiety, family breakdown and relationships 87% of the clients were satisfied or very satisfied with the service 59% reported a decrease in stress 15% average decrease in stress between pre and post tests “This session moved my life hugely” “ A votre intervention effective et non seulement psychologique” “Felt like a caterpillar coming in and a butterfly leaving :)”

16. North Simcoe Muskoka LHIN Our geographic area & health service providers 16 7 Hospitals 1 Community Care Access Centres (CCAC) 29 Community Support Services (CSS) 9 Community Mental Health (MHA) 3 Community Health Centres (CHC) 26 Long-Term Care Homes (LTCH) 465,000 population Higher prevalence of chronic conditions than the province 17% seniors

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18. NSM Counselling/Treatment (Walk in) Catholic Family Services led the implementation of the two pilots and has expertise in the provision of the service Implementation details are based on the evaluation of two Pilot Walk in Clinics (2013) weekly in Midland and monthly in Collingwood Goal is to have one walk in clinic each day in NSM LHIN at full implementation Catholic Family Services Simcoe (CFSS) continues to lead project and provide regional support for Intake and Clinical Supervision at all walk in clinics Some investment was needed to enhance Counselling Resources of partners who will provide counselling at the clinics Catholic Family Services Simcoe was the agency recommended to receive allocation for Counseling and Treatment $226,000 (2014-15) and $426,000 (2015-16) 18

19. Working With Your Local LHIN 19

20. LHINs Mandate: Health System Transformation 20

21. Shared Responsibility for Health System Integration Health service providers must identify opportunities to integrate the services of the local health system Obligation is individual and collective with the LHIN Must engage a “community of diverse persons and entities” 21

22. Working With Your Local LHIN Aligning with provincial priorities: “Patients First” 2016-2019 Integrated Health Service Plans Local advisory tables, steering committees, working groups, etc. Presenting solutions: Business cases, return on investment analysis, partnering with others 22