Hospital Sector

Transcription

1 Hospital Sector Schedule A: Funding Allocation Target Intended Purpose or Use of Funding Estimated 1 Funding Allocation FUNDING SUMMARY Global Funding (LHIN Allocation) Health System Funding Reform (HSFR) HBAM Funding Section 1: Health System Funding Reform (HSFR) QBP Funding Section 2: Wait Time Strategy Services ("WTS") Section 3: Provincial Program Services ("PPS") Section 4: Other Non-HSFR LHIN Funding Post Construction Operating Plan (PCOP) Base 2 Allocation 5 /One-Time Total 14/15 Estimated Funding Allocation Section 1: Health System Funding Reform - Quality-Based Procedures Rate Cancer- Surgery Cancer- Colposcopy Cardiac- Aortic Valve Replacement Cardiac- Coronary Artery Disease Cataracts- Bilateral Cataracts- Unilateral Chemotherapy Systemic Treatment Chronic Obstructive Pulmonary Disease Congestive Heart Failure Endoscopy Hip Replacement- Inpatient Rehabilitation for Unilateral Primary Hip Replacement- Unilateral Primary Knee Replacement- Inpatient Rehabilitation for Unilateral Primary Knee Replacement- Unilateral Primary Non-Cardiac Vascular- Aortic Aneurysm (AA) Non-Cardiac Vascular Lower Extremity Occlusive Disease (LEOD) Orthopaedics- Hip Fracture Orthopaedics- Knee Arthroscopy Paediatric- Neonatal Jaundice (Hyperbilirubinemia) Paediatric- Tonsillectomy Respriatory- Pneumonia Sroke- Transient Ischemic Attack (TIA) Stroke- Hemorrahage Stroke- Ischemic or Unspecified Vision Care- Retinal Disease Allocation /15 HSAA Schedules Page 1 of 14

2 Hospital Sector Schedule A: Funding Allocation Section 2: Wait Time Strategy Services ("WTS") General Surgery Pediatric Surgery Hip & Knee Replacement - Revisions Magnetic Resonance Imaging (MRI) Ontario Breast Screening Magnetic Resonance Imaging (OBSP MRI) Computed Tomography (CT) Other WTS Funding Section 3: Provincial Program Services ("PPS") Cardiac Surgery Other Cardiac Services Organ Transplantation Neurosciences Bariatric Services Regional Trauma Base 2 Base 2 One-Time 2 One-Time 2 Section 4: Other Non-HSFR Funding Base 2 One-Time 2 LHIN One-time payments MOH One-time payments LHIN/MOH Recoveries Other Revenue from MOHLTC Paymaster Other Funding (Not included in the Summary above) Grant in Lieu of Taxes Cancer Care Ontario 4 Ontario Renal Funding 4 Funding adjustment 1 ( ) Funding adjustment 2 ( ) Funding adjustment 3 ( ) Base 2 One-Time 2 * Targets for Years 2 and 3 of the agreement will be determined during the annual refresh process. [1] Estimated funding allocations are subject to appropriation and written confirmation by the LHIN. [2] Funding allocations are subject to change year over year. [3] Includes the provision of Services not specifically identified under QBP, WTS or PPS. [4] Funding provided by Cancer Care Ontario, not the LHIN. [5] All QBP Funding is fully recoverable in accordance with Section 5.6 of the H-SAA. QBP Funding is not base funding for the purposes of the BOND policy. 2014/15 HSAA Schedules Page 2 of 14

3 Hospital Sector ` Schedule B: Reporting Requirements 1. MIS Trial Balance Q2 Apr 01 to Sept Oct Oct Oct-2016 Q3 Oct 01- to Dec Jan Jan Jan-2017 Q4 Jan 01 to March May May May Hospital Quartery SRI Reports and Supplemental Reporting as Necessary Q2 Apr 01 to Sept Nov Nov Nov-2016 Q3 Oct 01- to Dec Feb Feb Feb-2017 Q4 Jan 01 to March Jun Jun Jun-2017 Year End 30-Jun Jun Jun Audited Financial Statements Fiscal Year Jun Jun Jun French Language Services Report Fiscal Year Apr Apr Apr /15 HSAA Schedules Page 3 of 14

4 Hospital Sector Site Name: TOTAL ENTITY Schedule C1: TOTAL ENTITY Performance Indicators Part I - PATIENT EXPERIENCE: Access, Effective, Safe, Person-Centered Performance Indicators Performance Target ** Performance Standard 90th Percentile Emergency Room (ER) Length of Stay for Admitted Patients 90th Percentile ER Length of Stay for Non-Admitted Complex (CTAS I-III) Patients 90th Percentile ER Length of Stay for Non-Admitted Minor Uncomplicated (CTAS IV-V) Patients Cancer Surgery: % Priority 4 cases completed within Target Cardiac Bypass Surgery: % Priority 4 cases completed within Target Cataract Surgery: % Priority 4 cases completed within Target Joint Replacement (Hip): % Priority 4 cases completed within Target Joint Replacement (Knee): % Priority 4 cases completed within Target Diagnostic Magnetic Resonance Imaging (MRI) Scan: % Priority 4 cases completed within Target Diagnostic Computed Tomography (CT) Scan: % Priority 4 cases completed within Target Rate of Ventilator-Associated Pneumonia Central Line Infection Rate Rate of Hospital Acquired Clostridium Difficile Infections Rate of Hospital Acquired Vancomycin Resistant Enterococcus Bacteremia Rate of Hospital Acquired Methicillin Resistant Staphylococcus Aureus Bacteremia Percent Of Stroke Patients Admitted To A Stroke During Their Inpatient Stay. Hospital Standardized Mortality Ratio (HSMR) Explanatory Indicators 30-Day Readmission Of Patients With Stroke Or Transient Ischemic Attack (TIA) To Acute Care For All Diagnoses. Percent Of Stroke Patients Discharged To Inpatient Rehabilitation Following An Acute Stroke Hospitalization. Readmissions Within 30 Days For Selected Case Mix Groups (CMGS) Hours 0.0 Hours 0.0 Hours 0.0 Percent 0 Percent 0 Percent 0 Percent 0 Percent 0 Percent 0 Percent 0 Rate 0.00 Rate 0.00 Rate 0.00 Rate 0.00 Rate 0.00 Ratio Part II - ORGANIZATIONAL HEALTH: Efficient, Appropriately Resourced, Employee Experience, Governance Performance Indicators Performance Target ** Performance Standard Current Ratio (Consolidated all sector codes and fund types) Total Margin (Consolidated all sector codes and fund types) Total Margin (Hospital Sector Only) Adjusted Working Funds Adjusted Working Funds / Total Revenue % Explanatory Indicators Ratio % Amount 2014/15 HSAA Schedules Page 4 of 14

5 Hospital Sector Quinte Health Care Quinte Health Care Corporation Site Name: TOTAL ENTITY Schedule C1: TOTAL ENTITY Performance Indicators Part III - SYSTEM PERSPECTIVE: Integration, Community Engagement, ehealth Performance Indicators Performance Target ** Performance Standard of Acute Alternate Level of Care (ALC) Days (closed cases) 0.00% Explanatory Indicators Repeat Unscheduled Emergency Visits Within 30 Days For Mental Health Conditions (Methodology Updated) Repeat Unscheduled Emergency Visits Within 30 Days For Substance Abuse Conditions (Methodology Updated) Part IV - LHIN Specific Indicators and Performance targets, see Schedule C3 * Targets for Year 2 and 3 of the Agreement will be set during the Annual Refresh process **Refer to H-SAA Indicator Technical Specification for further details. 2014/15 HSAA Schedules Page 5 of 14

6 Hospital Sector Schedule C2: Service Volumes Part I - Global Volumes Performance Target Performance Standard Emergency Department Total Inpatient Acute Day Surgery Inpatient Mental Health Inpatient Rehabilitation Complex Continuing Care Elderly Capital Assistance Program (ELDCAP) Ambulatory Care Weighted Cases 0 - Weighted Cases 0 - Weighted Visits 0 - Weighted Patient Days 0 - Weighted Cases 0 - Weighted Patient Days 0 - Inpatient Days 0 - Visits 0 - Part II - Hospital Specialized Services Primary Revision Cochlear Implants Cases 0 0 Base Incremental Cleft Palate HIV Outpatient Clinics Sexual Assault/Domestic Violence Treatment Clinics Cases 0 0 Visits 0 # of Patients /15 HSAA Schedules Page 6 of 14

7 Hospital Sector Schedule C2: Service Volumes Part III - Wait Time Volumes Base Incremental General Surgery Paediatric Surgery Hip & Knee Replacement - Revisions Magnetic Resonance Imaging (MRI) Ontario Breast Screening Magnetic Resonance Imaging (OBSP MRI) Computed Tomography (CT) Cases 0 0 Cases 0 0 Cases 0 0 Total Hours 0 0 Total Hours 0 0 Total Hours 0 0 Part IV - Provincial Programs Base Incremental Cardiac Surgery Cardiac Services - Catheterization Cardiac Services- Interventional Cardiology Cardiac Services- Permanent Pacemakers Cases 0 0 Cases 0 Cases 0 Procedures 0 Organ Transplantation Cases 0 Revsion Neurosciences Regional Trauma Number of Forensic Beds- General Number of Forensic Beds- Secure Number of Forensic Beds- Assessment Bariatric Surgery Medical and Behavioural Treatment Cases 0 0 Cases 0 Beds 0 Beds 0 Beds 0 Procedures 0 Cases /15 HSAA Schedules Page 7 of 14

8 Hospital Sector Schedule C2: Service Volumes Part V - Quality Based Procedures Volume Cancer- Surgery Cancer- Colposcopy Cardiac- Aortic Valve Replacement Cardiac- Coronary Artery Disease Cataracts- Bilateral Cataracts- Unilateral Chemotherapy Systemic Treatment Chronic Obstructive Pulmonary Disease Congestive Heart Failure Endoscopy Hip Replacement- Inpatient Rehabilitation for Unilateral Primary Hip Replacement- Unilateral Primary Knee Replacement- Inpatient Rehabilitation for Unilateral Primary Knee Replacement- Unilateral Primary Non-Cardiac Vascular- Aortic Aneurysm (AA) Non-Cardiac Vascular Lower Extremity Occlusive Disease (LEOD) Orthopaedics- Hip Fracture Orthopaedics- Knee Arthroscopy Paediatric- Neonatal Jaundice (Hyperbilirubinemia) Paediatric- Tonsillectomy Respriatory- Pneumonia Sroke- Transient Ischemic Attack (TIA) Stroke- Hemorrahage Stroke- Ischemic or Unspecified Vision Care- Retinal Disease 2014/15 HSAA Schedules Page 8 of 14

9 Hospital Sector Schedule C3: Local Indicators and Obligations 2014/15 HSAA Schedules Page 9 of 14

10 Schedule D Form of Compliance Declaration DECLARATION OF COMPLIANCE Issued pursuant to the Hospital Service Accountability Agreement To: From: Date: Re: The Board of Directors of the [insert name of LHIN] Local Health Integration Network (the LHIN ). Attn: Board Chair. The Board of Directors (the Board ) of the [insert name of Hospital] (the HSP ) [insert date] [insert date range - April 1, 201X March 31, 201x] (the Applicable Period ) The Board has authorized me, by resolution dated [insert date], to declare and attest to you as follows: After making inquiries of the HSP s Chief Executive Officer and other appropriate officers of the HSP and subject to any exceptions identified on Appendix 1 to this Declaration of Compliance, to the best of the Board s knowledge and belief, the HSP has fulfilled its obligations under the hospital service accountability agreement (the Agreement ) in effect during the Applicable Period. Without limiting the generality of the foregoing, the Board confirms that: (i) (ii) (iii) (iv) the HSP has complied with the provisions of the Local Health System Integration Act, 2006 and the Broader Public Sector Accountability Act (the BPSAA ) that apply to the HSP; the HSP has complied with its obligations in respect of CritiCall that are set out in the Agreement; every Report submitted by the HSP is complete, accurate in all respects and in full compliance with the terms of the Agreement; and the representations, warranties and covenants made by the Board on behalf of the HSP in the Agreement remain in full force and effect. Unless otherwise defined in this declaration, capitalized terms have the same meaning as set out in the Agreement. This Declaration of Compliance, together with its Appendix, will be posted on the HSP s website on the same day that it is issued to the LHIN. [insert name of Board Chair or other board member authorized by the Board to make the Declaration on the Board s behalf], [insert title] Page 1 of /15 HSAA Schedules Page 10 of 14

11 Appendix 1 - Exceptions Please identify each obligation under the H-SAA that the HSP did not meet during the Applicable Period, together with an explanation as to why the obligation was not met and an estimated date by which the HSP expects to be in compliance. Page 2 of /15 HSAA Schedules Page 11 of 14

12 Schedule E - Project Funding Agreement Template Project Funding Agreement Template Note: This project template is intended to be used to fund one-off projects or for the provision of services not ordinarily provided by the HSP. Whether or not the HSP provides the services directly or subcontracts the provision of the services to another provider, the HSP remains accountable for the funding that is provided by the LHIN. THIS PROJECT FUNDING AGREEMENT ( PFA ) is effective as of [insert date] (the Effective Date ) between: XXX LOCAL HEALTH INTEGRATION NETWORK (the LHIN ) - and - [Legal Name of the Health Service Provider] (the HSP ) WHEREAS the LHIN and the HSP entered into a service accountability agreement dated [insert date] (the SAA ) for the provision of Services and now wish to set out the terms pursuant to which the LHIN will fund the HSP for [insert brief description of project] (the Project ); NOW THEREFORE in consideration of their respective agreements set out below and subject to the terms of the SAA, the parties covenant and agree as follows: 1.0 Definitions. Unless otherwise specified in this PFA, capitalized words and phrases shall have the meaning set out in the SAA. When used in this PFA, the following words and phrases have the following meanings: Project Funding means the funding for the Services; Services mean the services described in Appendix A to this PFA; and Term means the period of time from the Effective Date up to and including [insert project end date]. 2.0 Relationship between the SAA and this PFA. This PFA is made subject to and hereby incorporates the terms of the SAA. On execution this PFA will be appended to the SAA as a Schedule. 3.0 The Services. The HSP agrees to provide the Services on the terms and conditions of this PFA including all of its Appendices and schedules. 4.0 Rates and Payment Process. Subject to the SAA, the Project Funding for the provision of the Services shall be as specified in Appendix A to this PFA. 5.0 Representatives for PFA. (a) The HSP s Representative for purposes of this PFA shall be [insert name, telephone number, fax number and address.] The HSP agrees that the 2014/15 HSAA Schedules Page 12 of 14 1

13 Schedule E - Project Funding Agreement Template HSP s Representative has authority to legally bind the HSP. (b) The LHIN s Representative for purposes of this PFA shall be: [insert name, telephone number, fax number and address.] 6.0 Additional Terms and Conditions. The following additional terms and conditions are applicable to this PFA. (a) (b) Notwithstanding any other provision in the SAA or this PFA, in the event the SAA is terminated or expires prior to the expiration or termination of this PFA, this PFA shall continue until it expires or is terminated in accordance with its terms. [insert any additional terms and conditions that are applicable to the Project] IN WITNESS WHEREOF the parties hereto have executed this PFA as of the date first above written. [insert name of HSP] By: [insert name and title] By: [insert name and title] [XX] Local Health Integration Network By: [insert name and title.] By: [insert name and title.] 2014/15 HSAA Schedules Page 13 of 14 2

14 Schedule E - Project Funding Agreement Template APPENDIX A: SERVICES 1. DESCRIPTION OF PROJECT 2. DESCRIPTION OF SERVICES 3. OUT OF SCOPE 4. DUE DATES 5. PERFORMANCE TARGETS 6. REPORTING 7. PROJECT ASSUMPTIONS 8. PROJECT FUNDING 8.1 The Project Funding for completion of this PFA is as follows: 8.2 Regardless of any other provision of this PFA, the Project Funding payable for the completion of the Services under this PFA is one-time funding and is not to exceed [X]. 2014/15 HSAA Schedules Page 14 of 14 3