Post on 10-Jul-2020
Mississauga Halton LHINCSS and MHampA Sector Meeting
June 11 2010
AgendaAgenda
Welcome and Agenda
Community Care Information Management Program (CCIM)
bull
Human Resource Information System (HRIS) Presentation
Herb Spence ndash
Stakeholder Engagement HRISEugene Cortes -
Project Lead CMHampA Sector HRISSajneet
Sodhi
ndash
Project Lead CSS Sector HRIS 60 min
Mississauga Halton LHIN ReCharge
Program Kristina Hall Executive DirectorNucleus Housing 15 min
~ BREAK ~ 15 min
CSS ndash
Common Assessment Project (CAP) Alan Fleming
ndash
Implementation LeadAshim
Rizki
ndash
Project Lead CCIM MH and CW LHIN 20 min
Finance Update Paulette Zulianello Senior Lead Funding and Allocation MH LHIN 10 min
MH LHIN Strategic Investmentsbull Aging at Home Update
Narendra Shah COOMH LHIN 35 min
Integration Feedback and Exercise(as per attached feedback focus on 2 areas for discussion training and back office integration)
Angela Jacobs Senior LeadPerformance and Integration MH LHIN 15 min
Canadian Red Cross Update Valerie Cook Integrated ManagerCanadian Red Cross CHS 5 min
QuestionsCommentsNext Meeting September 10 2010
Angela Jacobs 5 min
Community Care Information Management Program (CCIM)
Human Resource Information System
(HRIS) Presentation
Herb SpenceEugene CortesSajneet
Sodhi
4
Welcome
5
Community Care Information Management
HRIS PROJECT
CSS and CMHampA Sectors
June 2010
Presentation Agenda Introduction amp Overview HRIS Project Background amp Solution OverviewBenefits and Implementation ProcessTraining amp CommunicationsHRIS Support Centre LHIN Summary and Next
StepsQampA
7
Introductions
bull
Herb Spence Stakeholder EngagementBusiness Relationship -
CSS amp CMHampA Sectors HRIS Project
bull
Sajneet Sodhi Project Lead ndash
CSS Sector HRIS Project
bull
Larry Radzio Implementation Lead ndash
CSS Sector HRIS Project
bull
Paolo Primiani Implementation Lead ndash
CMHampA Sector HRIS Project
Presentation Objectives
bull
Provide a high level overview of the Community Care Information Management (CCIM) program
bull
Introduce the Human Resources Information Systems (HRIS) project and the benefits of participating
bull
Discuss the implementation and training process
Community Care Information Management (CCIM)ldquoCCIM strives to improve client outcomes by efficiently delivering the
right community health service at the right timerdquo
bull
Two major project streams designed to address sector priorities bull
Aim to create universally acceptable clinical and business standards across the sector and have the potential for cross-sector application
BUSINESS SYSTEMS COMMON ASSESSMENTS
Standards processes and tools to collect financial and statistical data including human resources and payroll
Tools to facilitate the collection and use of client information
Used for evidence-based decision support for planning integration and funding of community services
Create a sustainable approach to managing and measuring improvement in client outcomes over time
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
AgendaAgenda
Welcome and Agenda
Community Care Information Management Program (CCIM)
bull
Human Resource Information System (HRIS) Presentation
Herb Spence ndash
Stakeholder Engagement HRISEugene Cortes -
Project Lead CMHampA Sector HRISSajneet
Sodhi
ndash
Project Lead CSS Sector HRIS 60 min
Mississauga Halton LHIN ReCharge
Program Kristina Hall Executive DirectorNucleus Housing 15 min
~ BREAK ~ 15 min
CSS ndash
Common Assessment Project (CAP) Alan Fleming
ndash
Implementation LeadAshim
Rizki
ndash
Project Lead CCIM MH and CW LHIN 20 min
Finance Update Paulette Zulianello Senior Lead Funding and Allocation MH LHIN 10 min
MH LHIN Strategic Investmentsbull Aging at Home Update
Narendra Shah COOMH LHIN 35 min
Integration Feedback and Exercise(as per attached feedback focus on 2 areas for discussion training and back office integration)
Angela Jacobs Senior LeadPerformance and Integration MH LHIN 15 min
Canadian Red Cross Update Valerie Cook Integrated ManagerCanadian Red Cross CHS 5 min
QuestionsCommentsNext Meeting September 10 2010
Angela Jacobs 5 min
Community Care Information Management Program (CCIM)
Human Resource Information System
(HRIS) Presentation
Herb SpenceEugene CortesSajneet
Sodhi
4
Welcome
5
Community Care Information Management
HRIS PROJECT
CSS and CMHampA Sectors
June 2010
Presentation Agenda Introduction amp Overview HRIS Project Background amp Solution OverviewBenefits and Implementation ProcessTraining amp CommunicationsHRIS Support Centre LHIN Summary and Next
StepsQampA
7
Introductions
bull
Herb Spence Stakeholder EngagementBusiness Relationship -
CSS amp CMHampA Sectors HRIS Project
bull
Sajneet Sodhi Project Lead ndash
CSS Sector HRIS Project
bull
Larry Radzio Implementation Lead ndash
CSS Sector HRIS Project
bull
Paolo Primiani Implementation Lead ndash
CMHampA Sector HRIS Project
Presentation Objectives
bull
Provide a high level overview of the Community Care Information Management (CCIM) program
bull
Introduce the Human Resources Information Systems (HRIS) project and the benefits of participating
bull
Discuss the implementation and training process
Community Care Information Management (CCIM)ldquoCCIM strives to improve client outcomes by efficiently delivering the
right community health service at the right timerdquo
bull
Two major project streams designed to address sector priorities bull
Aim to create universally acceptable clinical and business standards across the sector and have the potential for cross-sector application
BUSINESS SYSTEMS COMMON ASSESSMENTS
Standards processes and tools to collect financial and statistical data including human resources and payroll
Tools to facilitate the collection and use of client information
Used for evidence-based decision support for planning integration and funding of community services
Create a sustainable approach to managing and measuring improvement in client outcomes over time
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Community Care Information Management Program (CCIM)
Human Resource Information System
(HRIS) Presentation
Herb SpenceEugene CortesSajneet
Sodhi
4
Welcome
5
Community Care Information Management
HRIS PROJECT
CSS and CMHampA Sectors
June 2010
Presentation Agenda Introduction amp Overview HRIS Project Background amp Solution OverviewBenefits and Implementation ProcessTraining amp CommunicationsHRIS Support Centre LHIN Summary and Next
StepsQampA
7
Introductions
bull
Herb Spence Stakeholder EngagementBusiness Relationship -
CSS amp CMHampA Sectors HRIS Project
bull
Sajneet Sodhi Project Lead ndash
CSS Sector HRIS Project
bull
Larry Radzio Implementation Lead ndash
CSS Sector HRIS Project
bull
Paolo Primiani Implementation Lead ndash
CMHampA Sector HRIS Project
Presentation Objectives
bull
Provide a high level overview of the Community Care Information Management (CCIM) program
bull
Introduce the Human Resources Information Systems (HRIS) project and the benefits of participating
bull
Discuss the implementation and training process
Community Care Information Management (CCIM)ldquoCCIM strives to improve client outcomes by efficiently delivering the
right community health service at the right timerdquo
bull
Two major project streams designed to address sector priorities bull
Aim to create universally acceptable clinical and business standards across the sector and have the potential for cross-sector application
BUSINESS SYSTEMS COMMON ASSESSMENTS
Standards processes and tools to collect financial and statistical data including human resources and payroll
Tools to facilitate the collection and use of client information
Used for evidence-based decision support for planning integration and funding of community services
Create a sustainable approach to managing and measuring improvement in client outcomes over time
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
4
Welcome
5
Community Care Information Management
HRIS PROJECT
CSS and CMHampA Sectors
June 2010
Presentation Agenda Introduction amp Overview HRIS Project Background amp Solution OverviewBenefits and Implementation ProcessTraining amp CommunicationsHRIS Support Centre LHIN Summary and Next
StepsQampA
7
Introductions
bull
Herb Spence Stakeholder EngagementBusiness Relationship -
CSS amp CMHampA Sectors HRIS Project
bull
Sajneet Sodhi Project Lead ndash
CSS Sector HRIS Project
bull
Larry Radzio Implementation Lead ndash
CSS Sector HRIS Project
bull
Paolo Primiani Implementation Lead ndash
CMHampA Sector HRIS Project
Presentation Objectives
bull
Provide a high level overview of the Community Care Information Management (CCIM) program
bull
Introduce the Human Resources Information Systems (HRIS) project and the benefits of participating
bull
Discuss the implementation and training process
Community Care Information Management (CCIM)ldquoCCIM strives to improve client outcomes by efficiently delivering the
right community health service at the right timerdquo
bull
Two major project streams designed to address sector priorities bull
Aim to create universally acceptable clinical and business standards across the sector and have the potential for cross-sector application
BUSINESS SYSTEMS COMMON ASSESSMENTS
Standards processes and tools to collect financial and statistical data including human resources and payroll
Tools to facilitate the collection and use of client information
Used for evidence-based decision support for planning integration and funding of community services
Create a sustainable approach to managing and measuring improvement in client outcomes over time
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
5
Community Care Information Management
HRIS PROJECT
CSS and CMHampA Sectors
June 2010
Presentation Agenda Introduction amp Overview HRIS Project Background amp Solution OverviewBenefits and Implementation ProcessTraining amp CommunicationsHRIS Support Centre LHIN Summary and Next
StepsQampA
7
Introductions
bull
Herb Spence Stakeholder EngagementBusiness Relationship -
CSS amp CMHampA Sectors HRIS Project
bull
Sajneet Sodhi Project Lead ndash
CSS Sector HRIS Project
bull
Larry Radzio Implementation Lead ndash
CSS Sector HRIS Project
bull
Paolo Primiani Implementation Lead ndash
CMHampA Sector HRIS Project
Presentation Objectives
bull
Provide a high level overview of the Community Care Information Management (CCIM) program
bull
Introduce the Human Resources Information Systems (HRIS) project and the benefits of participating
bull
Discuss the implementation and training process
Community Care Information Management (CCIM)ldquoCCIM strives to improve client outcomes by efficiently delivering the
right community health service at the right timerdquo
bull
Two major project streams designed to address sector priorities bull
Aim to create universally acceptable clinical and business standards across the sector and have the potential for cross-sector application
BUSINESS SYSTEMS COMMON ASSESSMENTS
Standards processes and tools to collect financial and statistical data including human resources and payroll
Tools to facilitate the collection and use of client information
Used for evidence-based decision support for planning integration and funding of community services
Create a sustainable approach to managing and measuring improvement in client outcomes over time
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Presentation Agenda Introduction amp Overview HRIS Project Background amp Solution OverviewBenefits and Implementation ProcessTraining amp CommunicationsHRIS Support Centre LHIN Summary and Next
StepsQampA
7
Introductions
bull
Herb Spence Stakeholder EngagementBusiness Relationship -
CSS amp CMHampA Sectors HRIS Project
bull
Sajneet Sodhi Project Lead ndash
CSS Sector HRIS Project
bull
Larry Radzio Implementation Lead ndash
CSS Sector HRIS Project
bull
Paolo Primiani Implementation Lead ndash
CMHampA Sector HRIS Project
Presentation Objectives
bull
Provide a high level overview of the Community Care Information Management (CCIM) program
bull
Introduce the Human Resources Information Systems (HRIS) project and the benefits of participating
bull
Discuss the implementation and training process
Community Care Information Management (CCIM)ldquoCCIM strives to improve client outcomes by efficiently delivering the
right community health service at the right timerdquo
bull
Two major project streams designed to address sector priorities bull
Aim to create universally acceptable clinical and business standards across the sector and have the potential for cross-sector application
BUSINESS SYSTEMS COMMON ASSESSMENTS
Standards processes and tools to collect financial and statistical data including human resources and payroll
Tools to facilitate the collection and use of client information
Used for evidence-based decision support for planning integration and funding of community services
Create a sustainable approach to managing and measuring improvement in client outcomes over time
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
7
Introductions
bull
Herb Spence Stakeholder EngagementBusiness Relationship -
CSS amp CMHampA Sectors HRIS Project
bull
Sajneet Sodhi Project Lead ndash
CSS Sector HRIS Project
bull
Larry Radzio Implementation Lead ndash
CSS Sector HRIS Project
bull
Paolo Primiani Implementation Lead ndash
CMHampA Sector HRIS Project
Presentation Objectives
bull
Provide a high level overview of the Community Care Information Management (CCIM) program
bull
Introduce the Human Resources Information Systems (HRIS) project and the benefits of participating
bull
Discuss the implementation and training process
Community Care Information Management (CCIM)ldquoCCIM strives to improve client outcomes by efficiently delivering the
right community health service at the right timerdquo
bull
Two major project streams designed to address sector priorities bull
Aim to create universally acceptable clinical and business standards across the sector and have the potential for cross-sector application
BUSINESS SYSTEMS COMMON ASSESSMENTS
Standards processes and tools to collect financial and statistical data including human resources and payroll
Tools to facilitate the collection and use of client information
Used for evidence-based decision support for planning integration and funding of community services
Create a sustainable approach to managing and measuring improvement in client outcomes over time
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Presentation Objectives
bull
Provide a high level overview of the Community Care Information Management (CCIM) program
bull
Introduce the Human Resources Information Systems (HRIS) project and the benefits of participating
bull
Discuss the implementation and training process
Community Care Information Management (CCIM)ldquoCCIM strives to improve client outcomes by efficiently delivering the
right community health service at the right timerdquo
bull
Two major project streams designed to address sector priorities bull
Aim to create universally acceptable clinical and business standards across the sector and have the potential for cross-sector application
BUSINESS SYSTEMS COMMON ASSESSMENTS
Standards processes and tools to collect financial and statistical data including human resources and payroll
Tools to facilitate the collection and use of client information
Used for evidence-based decision support for planning integration and funding of community services
Create a sustainable approach to managing and measuring improvement in client outcomes over time
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Community Care Information Management (CCIM)ldquoCCIM strives to improve client outcomes by efficiently delivering the
right community health service at the right timerdquo
bull
Two major project streams designed to address sector priorities bull
Aim to create universally acceptable clinical and business standards across the sector and have the potential for cross-sector application
BUSINESS SYSTEMS COMMON ASSESSMENTS
Standards processes and tools to collect financial and statistical data including human resources and payroll
Tools to facilitate the collection and use of client information
Used for evidence-based decision support for planning integration and funding of community services
Create a sustainable approach to managing and measuring improvement in client outcomes over time
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
CommonAssessment
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Common Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres
CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
HRIS Project Background
bull
Initiated by the Ministry of Health and Long-Term Care (MOHLTC) in August 2008
bull
Supports both the Community Mental Health and Addictions (CMHampA) and the Community Support Services (CSS) sectors with a HR and Payroll software solution Quadrantndash
Recently began supporting the Small and Complex Continuing Care Hospitals (SCCH) sector
bull
Organizations have been receiving training since February 2009
bull
Implementation with organizations began in March 2009
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
HRIS Project Milestones
Aug-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10Sep-08
MOHLTC Project
Announcement
Software Solution RFP
Issued
Initial Announcement
to Sectors
HRIS Training
HRIS Implementation
Creation of Advisory
Working Groups
Launched HRIS Support Centre
50th
Organization Fully
Implemented
Launched HRIS Webinar Series
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Classification Medium13
HRIS Solution Overviewbull
Quadrant is composed of a variety of modulesndash
Human Resourcesndash
Payrollndash
Schedulingndash
Self Service including QHRnet
bull
Hosted in a secure central environment
bull
CCIM is responsible forndash
Back-up amp maintenancendash
Applying patches and releases (ie tax updates)
bull
Solution meets all relevant security amp privacy regulations
bull
Organizations own and ONLY have access to their data
bull
Participating organizations receive a lifetime license for Quadrant
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Quadrant Modules
Human Resourcesbull Captures employee demographicsbull Position-centric design and
managementbull Configurable form templates and
process checklistsbull User and system based notifications
Payrollbull Ability to generate manual and
automated time cards bull Pay cycle managementbull Ability to adjust earnings deductions
and allowances bull Efficient manual automatic special
and retro pay processing
Schedulingbull Easy schedule creation and
administrationbull Applies to organizations with simple
or complex scheduling rulesbull Compatible with multi-site multi-
position andor multi-union work environments
Self Service including QHRnetEmployees have the ability to
bull View and edit personal demographic information
bull View and print pay statementsbull View and print work schedulesbull View and track benefit banks
A 20 minute Software Demo is in the package provided to you
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Benefits of Implementing the HRIS Software Solution Quadrant
Automates and streamlines HR and Payroll processesbull
Manual processes are automated leading to better use of time and resources
Allows for efficient OHRS data collection and reportingbull
Reduces back-office duplicationbull
Ensures the information is provided in the right format to MOHLTC and LHINs
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Benefits of Implementing the HRIS Software Solution Quadrant (continued)
Interfaces with the financial and statistical management solutionbull
Organizations can export human resources and payroll data and interface it with Microsoft Dynamics GP
bull
Compatibility with 3rd party applications using generic interfaces ndashminimum configuration effort to import as well as export data from and to other applications
Provides evidence-based information for system planningbull
Organizations will have the ability to generate reliable reports for resource planning data collection and information management
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
HRIS Project Eligibility
bull
CMHampA and CSS organizations are eligible to participate
bull
Organizations must have submitted a successful Ontario Healthcare Reporting Standards (OHRS)MIS Trial Balance
bull Organizations are encouraged to implement the software however
it is not mandatory
bull Current project end date is March 2012
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
18
Typical HRIS Project Implementation Process
Step 1
Step 8
Step 9
Step 4
Step 5
Step 6
Step 7
Step 2
Step 3
Go- Live
Participate in Parallel Testing
Configure Application Database
Complete HR amp Payroll training
sessions
Complete Implementation
Project Plan
Participate in Kick-Off Call
Complete Connectivity
Test
E-mail confirmation
of participation
HRIS Project Life Cycle
Start working together on
Starter Kits 1 2 and 3
ldquoLiverdquo Support for
participating organizations
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
19
Implementation - Testimonials
ldquoThe implementation team have been a great team to work with and have assisted us with all of our needs in an efficient and timely manner We look forward to our continued relationship and utilizing the softwarersquos full benefitsrdquo
ndash Karen Cutmore Support and Housing Halton
ldquoGreat news Upload was successful Followed instructions for Importing Quadrant HR Export into Microsoft Dynamics GP Worked like hot knife cutting through butter ndash so easyrdquo
ndash Victoria Best Links2care
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
HRIS Project Trainingbull
Training customized tondash
Reflect requirements of the sectorndash
Suit organizational needsbull
Courses currently available
Human Resources (mandatory) 2 days
Payroll (mandatory) 3 days
Year End Payroll (optional) 1 day
Report Writing 1 (optional) 3 days
HR Suite (optional) 2 days
Scheduling (optional) On Demand
QHRnet Basic End-Users and Admin Just-In-Time (Online CD)
bull
Future coursesQHRnet Leave Management (optional) To be determined
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
21
Training - Testimonials
ldquoWe are ready for live implementation of QHR this week The configuration and training have met our needs and will certainly cut down on the manual calculations that we presently do The reports set up will increase the reporting we do and give our Board of Directors a more thorough picture of our staffing costs hours etc The compatibility with GP will also greatly cut down on the time needed for the quarterly trial balancesrdquo
- Sheryl Niemienen SENACA Seniors Day Program
ldquoIt is an excellent training session Its clear a lot of work was done in preparation Its a lot of material to cover and I feel like Ive at least got a good start on the implementationrdquondash Susan Buono Summit House
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Communications
bull
Information sessions are held across all 14 LHINs Recently we presented to CMHampA and CSS organizations in HNHB and South West LHINs
bull
Webinar presentations for organizations interested in the HRIS project (over 140 CMHampA and CSS participants registered for four webinar sessions)
bull
Quarterly newsletters designed to provide the latest information as well as lessons learned and testimonials to all CMHampA and CSS organizations A Systems for Success newsletter was sent to all organizations and LHINs in March 2010
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
HRIS Support Centre
ldquoLiverdquo support available 800 AM ndash 600 PM EST except onweekends and holidays
To contact the HRIS Support Centre
CSScsshrisccimonca1-877-706-8094
CMHampA cmh_ahrisccimonca1-877-706-8095
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
24
Support - Testimonials
ldquoThank you very much for all the help last week on our manual payment for vacation payout I appreciate all that the support team have done for us the support team really went above and beyond The vacation pay also went through and all my co-workers thank the support teamrdquo
ndash Katalin Majoros Seniors Life Enhancement Centres
ldquoI need to point out how excellent the Support Center is They are very polite with an excellent response timerdquo
ndash Dipika Nayar Hospice of Peel (HeartHouse Hospice)
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
25
Participating Organizations To Date
bull
Participating organizations range in size (small medium and large) provide a variety of services and vary in degrees of complexity
bull
98 CMHampA and 112 CSS organizations have implemented or are currently implementing Quadrant across the province across all 14 LHINs
bull
Of these 46 CMHampA and 60 CSS have implemented the HRIS software solution Quadrant
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
26
MH LHIN HRIS Summary (as of May 2010)
Community Mental Health and Addictions (CMHampA) bull
In total there are 9
CMHampA organizations in the MH LHIN
bull
2 organizations are currently implementing the HRIS software solution Quadrant
bull
4
organizations are fully implemented with Quadrant
Please see the Appendix at the end of this presentation for a full list of participating organizations in the MH LHIN
Community Support Services (CSS)bull
In total there are 33 CSS organizations in the MH LHIN
bull
3
organizations are currently implementing the HRIS software solution Quadrant
bull
7
organizations are fully implemented with Quadrant
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Next Stepsbull
Talk to CMHampA and CSS organizations about their experiences implementing Quadrant
bull
For more information or if you would like to sign-up for the HRIS project please contact Saj
bull
The project lead will reach out to your organization to answer any questions
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
29
Appendix
bull
CMHampA Organizations Implemented and Implementing Quadrant
bull
CSS Organizations Implemented and Implementing Quadrant
bull
Number of CSS and CMHampA Organizations Currently Implementing Quadrant by LHIN
bull
Sample list of User Defined Folders (UDFs)bull
Sample list of Checklists
bull
Sample list of Reportsbull
Case Study St Josephrsquos Home Care
29
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
30
CMHampA Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CMHampA
Halton Alcohol and Drug Assessment Prevention and Treatment
Halton Recovery House
Hope Place Womens Treatment Centre
Summit House
Support and Housing Halton formerly Oakville Re-Entry Homes Incorporated
Supported Training and Rehabilitation in Diverse Environments
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
31
CSS Orgs Implemented amp Implementing Quadrant in the MH LHIN (as of May 2010)
Sector Organization Implemented Implementing
CSS
Dixie Bloor Neighbourhood Drop-In Centre
Hospice Of Peel Inc
Links2care (Georgetown)
Nucleus Independent Living Inc
MICBA Forum Italia Community Services
Peel Cheshire Homes Inc (Streetsville)
Peel Senior Link
Rehabilitation Foundation For The Disabled - Peel Region
SENACA Seniors Day Program - Halton Incorporated
Seniors Life Enhancement Centres
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
32
Number of CSS and CMHampA Organizations Currently Implemented and Implementing Quadrant by LHIN
32
LHIN of CSS Organizations
of CMHampA Organizations
Total per LHIN LHIN Name
LHIN 1 9 11 20 Erie St Clair
LHIN 2 5 10 15 South West
LHIN 3 3 4 7 Waterloo Wellington
LHIN 4 21 12 33 Hamilton Niagara Haldimand Brant
LHIN 5 5 2 7 Central West
LHIN 6 10 6 16 Mississauga Halton
LHIN 7 10 9 19 Toronto Central
LHIN 8 8 2 10 Central
LHIN 9 10 7 17 Central East
LHIN 10 6 5 11 South East
LHIN 11 8 11 19 Champlain
LHIN 12 10 4 14 North Simcoe Muskoka
LHIN 13 5 10 15 North East
LHIN 14 2 5 7 North West
Total all LHINs 112 98 210
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Sample List of User Defined Folders (UDFs)New Hire
ndash
Benefits Enrollmentsndash
Code of Conductndash
Criminal Records Checkndash
Employee Photondash
Letter of Offerndash
Foreign Workersndash
Reference Check
Educationndash
Education Fundingndash
HCA Challenge Programndash
Regional Orientationndash
Succession Planning or Staff Development Plans
Performance Managementndash
Arbitrationndash
Attendance Managementndash
Disciplinary Actionsndash
Grievancendash
Performance ReviewAppraisalndash
Probationary Review
Human Resourcesndash
Exit Interviewndash
Increment Datesndash
Recruitment amp Retention Grantsndash
Trial Periodndash
Transfersndash
Vacation Increments
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Sample List of User Defined Folders (UDFs) continuedhellip
Health amp Safetyndash
Annual Staff Immunizationndash
Drug Screenndash
HepB
Immunizationndash
Incident Reportndash
TB Immunizationndash
Occ
Health Formndash
Vision Testing
Leave Managementndash
Disability Rehabndash
Duty to Accommodatendash
Leave of Absencendash
MPICndash
Return to Workndash
WCBCritical Job InjuryHealth amp Safety Incident
Employer Propertyndash
Building Securityndash
Equipment RepairReplacendash
Facility Property-Employersndash
Insured Driver List
Service Recognitionndash
Rewards amp Recognition Rewardndash
Service Awards
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Sample List of Checklists
ndash
Submit Request for Hire to HRndash
Schedule Orientationndash
Verify Qualificationsndash
Prepare amp Send Offer Letterndash
Approved Staffing Request Form
ndash
Schedule Appointmentsndash
Hire Application in QHRndash
Administer TB Testsndash
Add Immunization Historyndash
Add Criminal Code UDFndash
Add Probationary UDF
ndash
Confirm Orientation Completion
ndash
Take Employee Photondash
Confirm Hire Datendash
Schedule Benefit Appointmentndash
Enter Probationary Periodndash
Enter Employment Infondash
Enter Payment Infondash
Enter Contact Informationndash
Enter Position amp Remunerationndash
Enter Deductions amp Benefitsndash
Complete Employee File
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Sample List of Reportsndash
Assigned Position Reportndash
Banks EE Benefit Reportndash
Contacts Reportndash
Deleted Leave Request Reportndash
Demographicndash
Direct Deduction Range Reportndash
Employee Banksndash
Employee Birthday by Month Reportndash
Employee Classndash
Employee Hire Reportndash
Employee Information Reportndash
Employee Pension Rate Reportndash
Employee Status Reportndash
Employee Termination Reportndash
Federal Provincial TD1 Reportndash
PA T4 Exception Reportndash
Pension Annual Report ndash
Withholding Report
ndash
Allowances Setup Reportndash
Banks Setup Reportndash
Chart of Accounts Reportndash
Checklist Reportndash
Competencies Configurationndash
Deductions Setup Reportndash
Master Position Vacancy Reportndash
MOH Headcountndash
Notification Group Addressesndash
Occupation and Pay Scalesndash
Availability by Position Reportndash
Available Shifts Reportndash
Basic Schedule Filterndash
Daily Staffing Analysisndash
Filter Schedule by Open Shiftsndash
EFT File Summary Reportndash
Employee T4ndash
Employer T4
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Case Study St Josephrsquos Home Care Hamilton
Presented by Steve Moore Manager Business amp Systems St Josephrsquos Home Care
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Who is St Josephrsquos Home Carebull
A member of the St Josephrsquos Health System which includesndash
St Josephrsquos Villandash
St Josephrsquos Healthcare Hamiltonndash
St Maryrsquos Hospital Kitchenerndash
St Josephrsquos Health Centre Guelphndash
St Josephrsquos Life care Centre Brantford
bull
Our part of the continuum of care is Home Carebull
Our programs includendash
Visiting Shift and Specialty Nursing contracts with the HNHB CCAC
ndash
PSW HSW Supportive Housing programsndash
PSW Specialty programs such as Constant Care amp Caregiver Relief
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Why did we choose to implement the Quadrant HRIS Solution1
Faced with OHRS Reporting
2
No existing system to track and report on earned hours or other statistics
3
Existing payroll HR solution high processing fees but limited benefits
4
Hours to be paid keyed in as totals per pay period making monthly reporting and analysis difficult With labor being our major cost imprecise accruals made variance reporting difficult
5
Tracking and reporting of banks such as vacation and sick time was very manual
6
In a four union environment seniority calculations were a real chore
7
No opportunity to import timecard data
8
Applying pay rate increases mid-pay period was a lot of work
9
Poor centralized HR functionality
10
Poor reporting on payroll HR data
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Our Implementation Processbull
Initial contact with CCIM ndash
March 2009bull
Became aware of both HRIS (Quadrant) and MIS (Dynamics GP) solutionsbull
Decided to proceed with HRIS (Quadrant) solution firstbull
Implementation consultants assigned and project plan created ndash
June July 2009
bull
Go Live target set for first pay period in 2010bull
First training HR and Payroll ndash
Project Lead ndash
Steve Moore ndash
June 2009bull
Main training for three staff HR and Payroll ndash
September 2009bull
HR Suite Training ndash
Project Lead ndash
Steve Moore ndash
November 2009bull
Configuration complete by Mid-November 2009bull
Parallel testing complete by Early December 2009ndash
Simulated parallel run Actual payroll from old system re-processed in Quadrant on an off-week
bull
Go Live successful on targetbull
Report writer 1 training ndash
Project Lead ndash
Steve Moore ndash
February 2010
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
What is nextbull
Implement HR Suite functionalityndash
Competenciesndash
User Defined Foldersndash
Checklistsndash
Notifications
bull
QHR Net which provides forndash
Internet access for employees to pay statementsndash
Opportunity to allow employees to update their own demographics
bull
Demonstration on Training and Scheduling modulesbull
Advanced Report Writer training
bull
Ongoing membership in HRIS Advisory Working Group
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Challenges
bull
TIME bull
Chart of Accountsndash
OHRS Restrictionsndash
Understanding the algorithms used in Quadrant processingndash
Because Dynamics GP not implemented first there was a need to negotiate back and forth between HRIS and MIS Implementation teams
bull
Lack of Configuration training up frontbull
Lack of technical documentation
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Rewardsbull
Trainers are experienced and excellent and the training materials used were actually produced by those same trainers
bull
Trainers use ldquoParking Lotsrdquo
when they cannot answer questions then they get the answers and provide them in class or if necessary via email if the class has already finished
bull
Strong implementation Teamsndash
Some you meetndash
Some you donrsquotbull
Experienced implementation teams bring strong actual experience and methodologies
bull
Very good help desk Support personnel strong on payroll amp HR processes with available more technical support when needed
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Summarybull
Our entire list of concerns over our old solution have been resolved with Quadrant but specificallyndash
Of 290 employees we efficiently import payroll data for all but
6ndash
We have vastly improved payroll related controls thanks to an improved ability to balance approved timecard data against hours and dollars about to be processed in Quadrant
ndash
We can now easily apply mid-pay period rate increases
bull
We expect to Go Live with Dynamics GP in late summerbull
We look forward to working with features of Quadrant that will be a bonus for usndash
HR Suitendash
QHR Netndash
Training modulendash
Scheduling modulendash
Other modules that may comendash
Advanced Report Writer training
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Contact Information
bull
You will find that CCIM has a strong HRIS implementation and training team however if I can be of any assistance
bull
I am an active member of the HRIS Advisory Working Group
bull
You can also contact me atndash
smoorestjhcca
ndash
Phone (905) 522-6887 ext 2254
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Thank You
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Mississauga Halton LHIN ReCharge Program
Kristina Hall
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Break
15 Minutes
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CSS ndash
Common Assessment Project (CAP)
Ashim
RizkiAllen Flaming
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Presentation for
CSS amp MHampA Sector Meeting
June 11th 2010
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CSS CAP Project
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CSS CAP Project
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CSS Cap Project
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CSS CAP Project
Project Team for Community Care Information Management (CCIM)
bull
Ashim
Rizki Project Lead ndash MH amp CW LHINs
bull
Allen Flaming Implementation Lead ndash MH LHIN
LHIN Project Teambull
Judy Bowyer MH LHIN
bull
Priti Patel MH LHIN
bull
Steering Committee ndash MH LHIN CSS Providers
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Infrastructure amp Operations Standards Security Privacy amp Risk Management Transition
Community Care Information Management (CCIM) Program
CCAC CSS CMHampA LTCH CHC SCCH
Local Health Integration Networks (LHINs)
Integrated Data Strategy
AssessmentProjects
Business Systems
Common IntakeAssessment
Tool
Long Stay Assessment
Software
ManagementInformation
Systems
Human Resources Information
Systems
ManagementInformation
Systems
Human Resources Information
Systems
Management Information
Systems
HumanResourcesInformation
Systems
ManagementInformation
Systems
Human Resources Information
Systems
interRAI Community
Health Assessment
Ontario Common
Assessment of Need
Resident Assessment Instrument
MDS 20
Management Information
Systems
Completed and transitionedInitiation stage Pilot stage Currently rolling out
CCAC = Community Care Access Centres CSS = Community Support Services CMHampA = Community Mental Health and AddictionsLTCH = Long-Term Care Homes SCCH = Small amp Complex Continuing Care Hospitals CHC = Community Health Centres
Management Information
Systems
Integrated Assessment Record
ScreeningCapability
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Referral
Screener ToolSelf administered or org
administered
Service PlanningRight Service for Right Client
Data Sharing
Data Submission
More intensive servicesSupportive HousingAdult Day Program
Need for a comprehensive assessment
Less intensive servicesMeals Delivery
Transportation
Drop-in Centre
Outcomes
Out of SCOPE
In SCOPE
Reports
Data Management
CSS CAP project scope
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
How we are working in partnershipInformation Management Alliance
CSS CAP Steering Committee
Working and Reference Groups LHIN Implementation Steering Committees
LHIN n
etc
Mississauga Halton LHIN Consent Management Aboriginal
Data Mgmt Mobility
Shared Ax Reports
Best Practices -DQ Education
Screener Cross Sector
Common Assessment
PROJECT TEAM Project Management
BusinessProcess EducationImplementation
Communications
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CSS CAP implementation model
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CSS CAP Project ndash Next Steps
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CSS CAP Project
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CHOICES ndash ALL Same Time
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
CHOICES ndash GROUPS Differing Times
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Take Away Considerations
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Take Away Considerations
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
MHLHIN Financial Update
Paulette Zulianello Senior LeadFunding and Allocation
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
TRAINING
Took place June 4th
to June 10th
2 more in case you have missed out
CMHampA ndash
June 15th
1200 to 130 pm
CSS ndash
June 16th
930 to 1100 am
Last Chance
Q4 CAT Reporting and ARR
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Tips and Tools
Reminder ndash
Follow each step in sequence
Q4 flat file must successfully upload to WERS before working on ARR ( keep both open until complete)
Use CAT version 25 not 21
Print entire report not each page
Community Analysis Tool (CAT User Guide 30)(troubleshooting pg 61)
CAT Q4 Reporting Quick Guide (pg 4 all 16 steps)
ARR HSP Guide V11bull `
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Tips and Tools (contrsquod)
Auditors can print Auditorrsquos Report on own Letterhead
No exception in 200910 ndash
all must procure Auditrsquos Report
Accrual information not requiredNo ARR statistics ndash
only Q4 CAT
Make sure required variances are explained
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Tips and Tools (contrsquod)
Technical contact ndash
KimHewittontariocaCMHampA ARR contact ndash
VivianTsangontarioca
CSS ARR contact ndash
KelvinWongontariocaMirella and myself Q4 and ARR ndash
due June 30
Supplementary Reporting for Initiatives-
June 30th
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
HST is coming July 1 2010 Harmonized Sales Tax Simple Comparison
Today July 1Sale
$10000
$10000
GST 5
500
PST 8
800
HST 13
1300
Total $11300 $11300
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Example PST-Taxable PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
800
HST 13
_______
1300
Total
$ 11300
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
_______
(656)
GSTHST rebate
(250)
(906)
NET COST $11050
$10394
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Example PST-Exempt PurchaseToday
July 1
Purchase
$10000
$10000
GST 5
500
PST 8
HST 13
________
1300
Total
$ 10500
$11300
GST Rebate
50
(250)
(250)
HST Rebate
82
________
(656)
GSTHST rebate
(250)
(906)
Net cost
$ 10250
$10394
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Combined Rebate Factor OntarioJuly 1
Purchase
$10000
HST 13
1300 x 6969 = 906
Total
$11300
GST Rebate 50 (250)
HST Rebate 82 (656)
GSTHST rebate
(906)
Net cost
$10394
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Net impact of HST (Incremental Effect)
bull PST-
taxable
1105rarr
10394
656 decrease
bull PST-
exempt
1025rarr
10394
144 increase
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Whats Taxable Under the HST and Whats Not
Clothing and Footwear
GST-taxable before
July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Adult Clothing 5 8 No (remains 13)
Childrens Clothing 5 No PST No (remains 5)
Shoe Repair Service 5 8 No (remains 13)
Childrens Footwear 5 No PST if $30 or less No for footwear up to size 6 (remains 5)
Tailoring Services 5 8 No (remains 13)
Dry Cleaning ServiceDry Cleaning Service 55 No PSTNo PST Yes (changes to 13)Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Whats Taxable Under the HST and Whats NothellipcontrsquodFood and
BeveragesGST-taxable
before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable
under the HST
Basic Groceries (eg Dairy Meat Vegetables Canned Goods)
No GST No PST No HST
Snack Foods (eg Chips Pop)
5 8 No (remains 13)
Qualifying Prepared Food and Beverages Sold for
$400 or Less
5 No PST No (remains 5)
Restaurant Meals for More than $400
5 8 No (remains 13)
Alcoholic Beverages 5 10-12 HST 13[1]
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Whats Taxable Under the HST and Whats NothellipcontrsquodHome Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Cable Television Services 5 8 No (remains 13)
Cell Phone Services 5 8 No (remains 13)
Municipal Water No GST No PST No HST
Home Maintenance Equipment 5 8 No (remains 13)
Home Phone Services 5 8 No (remains 13)
Home Service Calls to Repair Free-
Standing Appliances such as Stoves Refrigerators Washers Dryers and
Televisions
5 8 No (remains 13)
Home Insurance No GST 8 No (remains 8)
Electricity and Heating (eg Natural GasOil for Home)
5 No PST Yes (changes to 13)
Internet Access Services 5 No PST Yes (changes to 13)
Home Service Calls by ElectricianPlumberCarpenter to Maintain
or Repair Furnace Leaky Faucets Bathtub Toilet Electrical Wiring etc
5 No PST Yes (changes to 13)
Landscaping Lawn-Care and Private Snow Removal
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Whats Taxable Under the HST and Whats NothellipcontrsquodAccommodation Travel and
Passenger Transportation Services
GST-taxable before July
1
2010PST-taxable before
July
12010Is there a change to the amount of tax
payable under the HST
Luggage Briefcases Bags etc 5 8 No (remains 13)
Municipal Public Transit No GST No PST No HST
GO Transit No GST No PST No HST
Air travel originating in Ontario and terminating in the US[2]
5 No PST No (remains 5)
Air travel originating in Ontario and terminating outside of Canada and the US[3]
No GST No PST No HST
Rail boat and bus travel originating in Ontario and terminating outside of
Canada
No GST No RST No HST
Hotel Rooms 5 5 Yes (changes to 13)
Taxis 5 No PST Yes (changes to 13)
Campsites 5 No PST Yes (changes to 13)
Domestic Air Rail and Bus Travel originating in Ontario
5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Whats Taxable Under the HST and Whats NothellipcontrsquodMotorized Vehicles
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Vehicle Parts 5 8 No (remains 13)
Short-Term Auto Rentals 5 8 No (remains 13)
Lease of a Vehicle 5 8 No (remains 13)
Child Car Seats and Booster Seats 5 No PST No (remains 5)
Auto Insurance No GST No PST No HST
Labour
Charges to Repair Vehicle 5 8 No (remains 13)
Oil Change 5 8 No (remains 13)
Tires 5 8 No (remains 13)
Window Repair 5 8 No (remains 13)
Purchase of Vehicle from Dealer 5 8 No (remains 13)
Boats 5 8 No (remains 13)
Snowmobiles 5 8 No (remains 13)
Recreational Vehicles 5 8 No (remains 13)
Private Resale of Car (including Registration)
No GST 8 Yes[4] (changes to 13)
GasolineDiesel 5 No PST Yes (changes to 13)
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Whats Taxable Under the HST and Whats Nothellipcontrsquod
Professional and Personal Services
GST-taxable before July 1 2010
PST-taxable before July 12010
Is there a change to the amount of tax payable under the HST
Child Care Services No GST No PST No HST
Legal Aid No GST No PST No HST
Coffins and Urns Purchased Separately from a Package of Funeral
Services
5 8 No (remains 13)
Fitness Trainer 5 No PST Yes (changes to 13)
Hair StylistBarber 5 No PST Yes (changes to 13)
Esthetician Services (eg Manicures Pedicures Facials)
5 No PST Yes (changes to 13)
Funeral Services 5 No PST Yes (changes to 13)
Legal Fees 5 No PST Yes (changes to 13)
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
HARMONIZED SALES TAX - Conclusion
No affect on Revenue-
since GST rules apply
Taxable expenses 656 decrease
Non-taxable expenses 144 increase
144 increase applies to services and energy costs that were previously PST exempt
Slight changes to OHRS account description not the account numbers
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
MH LHIN Strategic Investments Aging at Home Update
Narendra Shah
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Aging At Home Peer Exchange Forum May 10-11 2010 MH LHIN
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
I
Reduce ALC days and LOS in hospitalsII
Reduce demand (wait list) for LTC homesIII
Reduce unnecessary ER visits
Mississauga Halton LHINrsquos Strategic Approach to A H
Strategic Objectives
I
Invest in Seniors with Complex Needs (usually 75+ age) in the communityII
Invest in LTC homes to reduce ERhospitalization of 4000+ residents and increase LTC homes capacity to care for ldquohigher needrdquo
seniorsIII
Use proven common set of assessmenteligibility tools (RAI family) across all sectors-home care SDL ADP LTC and CCC to ensure right care right setting at the right time and right cost
How
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Acute Care FY 0708 FY 0809 FY 0910 (1)Change to 0910
FY 0708 FY0809
Total Days 354055 372563 355182 03 -47
Total Pts 60864 61408 63077
Avg LOS 582 607 563 -32 -72
Total ALC Days 35844 47650 32918 -82 -309
Total ALC Pts 2174 2432 2623 206 78
Avg ALC LOS 1649 1959 1255
ALC 1010 1280 927 -82 -276
(1) Q4 0910 Projection using average Q4 proportion of 0708 and 0809 and Q3 YTD year-over-year average growth
MH LHIN Trend in ALC Day amp Patients 2008-09-2010
353 absolute point reduction in ALC Days in 0910
Pre-AHPre-AH Impact of AHImpact of AH
36 27
-239 -359Results
Growth
Despite growth we have good results
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Source MH LHIN Daily ALC Census
151
67
6 Month Average
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
High Risk Seniors (MAPLe
3+)Clients taken from Hospitals Community and LTC Sectors
Integral part of Joint Discharge Process in hospitals and CCAC
201011Additional Performance
Requirements
Reform of SH to Supports for Daily
LivingFocus on Reducing LTC Needs
247 Integrated ApproachLHIN-wide Mobile Capacity
Extensive Interaction with Hospitals and CCAC
$247M
NewClients
740
Expand to Support difficult cases in Hospitals and LTCHs Clients assisted to avoid ERHospiitalReduce ALC
ABISignificant outreach to Hospitals and LTCHs $49M
LHIN-wide ApproachIntegrated Transportation $19M
Reduce LTCER DemandUse of Care Giver Stress (CGS) Tool
Enhanced Respite CareBlock of Time $39M270
Integrated Home MakingMaintenance$22M
All referrals from CCACHigher Needs ndash
MAPLe
3Reduce LTC Demand
Adult Day ServicesSupport more ldquoat riskrdquo
Seniors$84M385
Stand-alone Transportation Services $15M
Transformation of CSS Sector to Focus on Frail ElderlyTransformation of CSS Sector to Focus on Frail Elderlyto Stay at Home Safelyto Stay at Home Safely
Pre-LHIN 200708 CSS Performance
Requirements
Objective Increase Capacity to Reduce Dependence on Institutions (LTC and Hospital Sector)
$343M
Clients
Balanced BudgetClient Satisfaction
Supportive HousingMost clients MAPLe
12sNo 247 support
Limited integration with hospitals
$135M
Adult Day ServicesMost clients MAPLe
12s $55M
ABIResidential with Community Outreach $36M
Respite CareDay-To-Day Caregiver Relief
$29M
Home MakingMaintenance $10M
Other CSS $63M
Other CSS $77M
$537M
Support Higher Need ldquoAt Riskrdquo
SeniorsSupport Higher Need ldquoAt Riskrdquo
Seniors
SILO Integrated ApproachSILO Integrated Approach
Increase of $194M
bull
Free Existing Hospital Capacity
bull
Right Placements in LTC Sector by CCAC
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
99
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
4100 Beds 27 homes
Convalescent Care Program Post Inn
Convalescent Care Program Post Inn
Restore Program ‐
MLCRestore Program ‐
MLC
220 bed LTC Facility at Trillium
West Toronto ndash 54
4100 Beds 27 homes
Dialysis at 2 homesDialysis at 2 homes
Behavioural Unit ndash
Sheridan
Villa
Behavioural Unit ndash
Sheridan
Villa
Psycho Geriatrc
Outreach
ABI Outreach
NP Program
Quality
Improvement
with OHQC ndash 8
Homes
Specialization
Quality Im
provement
MH LHIN MH LHIN ndashndash
Transformation of LTC SectorTransformation of LTC Sector
Pre‐LHIN LHIN ndash February 2010
Integration
(CSS amp CMHA with
LTC
Sector)
Integration
(with
Hospitals amp
CCAC)
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
100
Impact of A H Initiatives on MH LHIN Allocation By Sector (in Millions)
LHIN Allocation
200708
(Actual)
Pre-Aging Home
200910 Note 1
(Q4 Forecast)
Change
Hospitals $7135313 $7698639 789
Long Term Care Homes 1466112 1629215 1112
CCAC 1016853 1160379 1411
Community Support Services 171620 222742 2979
Supportive Housing amp SDL 134991 216294 6023
Community Mental Health 214362 239666 1180
Addictions Program 38256 42531 1117
ABI 36236 48923 3501
Total 10213743 11258389 102Note 1
0910 Data is based on MH LHIN Q3 forecast report sent to Ministry in Dec 2009
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
ChronicDisease
s
CHFCOPD
ChronicDisease
sCHFCOPD
Hom
e
Careby
CCAC
Hom
e Careby
CCAC
Adult Day
Program
s
Adult Day
Program
s
Specialize
d
Geriatric
Outreach
Specialize
d
Geriatric
Outreach
Home HelpMaintHome Makin
g
Home HelpMaintHome Makin
g
247
Crisis
Response
toMental Health ampAddictio
n
247
Crisis
Response to
Mental Health ampAddictio
n
ObjectivesLOSALCAdmission
Avoidance
ObjectivesER Use
Treatment Time
ER
Objectives Demand
Right Persons
27 Homes 4100 Beds
LTCH
CCAC EnhancedCCAC Enhanced
Transitional Beds in
Hospitals ndash 41 beds
Transitional Beds in
Hospitals ndash 41 beds
MLC Restore ‐
26
beds
MLC Restore ‐
26
beds
ABI OutreachABI Outreach
Capacity Enhancement inHomeCommunity
Transitional Capacity
CCACCSS CMHA
SDL SDL
Continenc
e
Mgmt75+
Continenc
eMgmt75+
NPrsquosInLTC
NPrsquosInLTC
Geriatri
c
System
Mgmt75+
Geriatri
c
SystemMgmt75+
Enhance
d
Respite
Enhance
dRespite
Psycho‐
geriatric
Outreac
h
Psycho‐
geriatricOutreac
h
Complex Continuing Care Reform ndash
300+ bedsComplex Continuing Care
Reform ndash
300+ beds
Regional Behaviour UnitRegional Behaviour Unit
MH LHIN Aging at Home Strategic ApproachMH LHIN Aging at Home Strategic ApproachRight Care Right Place Right Time
Convalescent
Program Post Inn ‐20
beds
Convalescent
Program Post Inn ‐20
beds
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Dementia
amp
Alzheimer
rsquos
Outreach
amp Day
Programs
Urgent Falls Progra
m
Urgent Falls Progra
m
Transportation
Enhanced PalliativeEnhanced Palliative
Sheridan VilliaBehavioural Unit ‐
19Sheridan Villia
Behavioural Unit ‐
19
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
SDLER Avoidance
ERsAvoidanceStrategies
247 Crisis Service For
Mental Health amp Addictions
CDPMMgmt
UrgentGeriatric
Clinic
NPsLTC Homes
200910
201011
MH LHIN Aging at HomeMH LHIN Aging at HomeInvestments Implications on ER ImprovementInvestments Implications on ER Improvement
Right Care Right Place Right Time
FallsClinic
CCAC Followup on all 75+
From ER
Palliative End of Life
Capacity in Home Care
1123 encounters1523 ER visits
averted
1046 Visits
8000
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Performance of MH LHINrsquos Top Three Initiatives in Years 1amp 2 which we will invest more in this Fiscal Year
Innovative and Best Practice Initiatives
bull Enhanced Home Care
bull Supports in Daily Living
bull Restore Program
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
MH CCAC Enhanced Services to Frail Seniors 2009-10
104
Home First Program ndash Hospital ReferralsStay at Home Program
WAH ndash LTC WAH ndash
Enhanced
MAPLe
Score 0910 Actual Clients (March 31 2010)
1 2 3 0
2 5 3 0
3 57 63 29
4 107 124 126
5 70 51 58
TOTAL Clients 241 244 213
Client Avg
MAPLe
(per above) 399 389 414
Client AvgMon
PSW hours
Before 60 Days
130
After 60 Days
108
Before 30 Days
882
After 30 Days
857
Before 30 Days
837
After 30 Days
856
Client Avg
LOS on
Enhanced Service27 months 51 months 83 months
734 717 864
Source MH CCAC March 31 2010
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
105
Major Transformation of ldquoSupportive Housingrdquo to Supports for Daily Living ndash lsquoHub amp Spokersquo 20080910 Results
(1) MAPLe Pre‐SDL Client
GroupSDL Client
Group1 45 132 28 333 104 1894 64 1635 22 84
Avg
Score 296 356TOTAL Clients 263 482
Age Pre‐SDL Client
GroupSDL Client
Grouplt65 4 9
65‐74 27 9975‐84 90 21385+ 207 256
Avg
Age 859 800TOTAL Clients 328 577
813512
Referrals FY 0809 Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTAL
Hospital 0 11 5 23 81 120Non‐Hospital
Restore 0 0 2 0 2 4CCAC 88 30 83 80 76 357Other 0 1 0 13 11 25
Sub‐total 88 31 85 93 89 386
TOTAL 88 42 90 116 170 506
(1) As per available data
In buildings with high concentration of seniors
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
106
Supports for Daily Living ndash Mobile 20080910 Results
MAPLe SDL Client
Group
1 0
2 1
3 38
4 45
5 15
Avg
Score 375
TOTAL Clients 99
Age SDL Client
Grouplt65 2
65‐74 2475‐84 3485+ 39
Avg
Age NATOTAL Clients 99
Referrals Q1 0910 Q2 0910 Q3 0910 Q4 0910 TOTALHospital 4 9 11 17 41Non‐Hospital
Restore 0 0 0 2 2CCAC 5 25 14 7 51Other 1 0 2 2 5
Sub‐total 6 25 16 11 58
TOTAL 10 34 27 28 99
606737
Nimble amp Timely response
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
112
ldquoMore health care is not always better for individuals or for populationsrdquo
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Next Steps
bull Ministry expects LHINs to reallocate funds where initiatives are
not meeting outcomes or to support other initiatives that have higher success
bull We will review Year 2 results in the next 2 months and where investments are not meting performance objectives adjustments and changes will be considered
bull Finalize Year 3 funding-all one-time subject to performance expectations
bull Province-wide evaluation of A H by ICES (Ministry sanctioned)
bull LHIN evaluation of SDL
bull MH LHIN Knowledge Exchange Forum for all A H investments
bull September 29 2010mdashHOLD THIS IMPORTANT DATE
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Integration Feedback
Angela Jacobs
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Remember the Question
Given the current economic constraints that we expect to see over the next couple of years what do you see as being the best integration opportunities to sustain or improve the system
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Feedback Summary1
Back Office Integrationa)
Procurement of goods (consumables)b)
IT costsplanningsoftwarec)
Sharing ldquoexpertsrdquo
ndash
HRFinancebookeepinglegal2
Education and Traininga)
Sharing educational and skill enhancement opportunities
b)
Training of the system eg discharge plannerssocial workersCCAC regarding community services
3
Transportation4
Electronic Connections
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Summary1
Back Office Integrationbull
MH LHIN has a Procurement Committee chaired by John Simpson Senior Account Executive Shared Services West
bull
Shared Services West provides procurement services to its four hospital members and one non-member hospital
bull
Investigating opportunities ndash
whether new or existing contracts negotiated by SSW may be extended to our HSPs in the MH LHIN by consolidating existing or new contracts
bull
Everyone participated in the SSW survey
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Summary1
Education and Training example
bull
MH LHIN MHampA HSPs through SIGMHA (System Integration Group for Mental Health and Addiction) established an Education and Training Task Team
bull
Focused on building a sustainable Education Program
bull
Surveyed all HSPs regarding learning needs
bull
Held 6 workshops ndash
attendees included service providers front line staff clients and families intake staff etc
bull
Self-sustaining in terms of funding
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Summarybull
Now has transitioned into The Education Implementation Work Group to lead the development of a sustainable education and training program for service providers clients families and the community at large within the Mississauga Halton LHIN
bull
Purpose is The Education Implementation Group will
To establish a LHIN-wide education and training program focused on SIGMHArsquos
strategic directions and the results of on-going learning needs surveys and other identified training needs
bull
Possible new workshopsbull
Transitional Aged Youthbull
Diversitybull
Community Workshops for Clients and Familiesbull
Concurrent Disorder Training
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Questions
bullWhat are the initial steps the CSS sector needs to do to move towards this kind of model for training
bullWhat are the training needs required by the community sector as a whole (CSS + MHampA)
bullWhat are the initial steps needed to organize this community training
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
Canadian Red Cross Update
Valerie Cook
COMMENTS QUESTIONS
COMMENTS QUESTIONS