Haliburton County Health Services Integration Transition Plan June 25, 2014
January 2013 - Central East LHIN Community Health Services Integration Strategy Cluster-based service delivery model through integration of frontline services, back office functions, leadership and/or governance to: improve client access to high-quality services create readiness for future health system transformation make the best use of the public s investment Hospitals were included in the Northumberland and Haliburton County City of Kawartha Lakes Processes 2
HKL Integration Planning Team Organizations Community Care City of Kawartha Lakes SIRCH Community Services Community Care Haliburton County Victorian Order of Nurses, Ontario Branch Ross Memorial Hospital Haliburton Highlands Health Services 3
What was proposed? The creation of One Entity (one organization) in Haliburton County, with a single board of governors, accountable for providing the LHINfunded hospital and community services. Confirmation of two existing entities in the City of Kawartha Lakes, Ross Memorial Hospital (RMH) and Community Care City of Kawartha Lakes (CCCKL), who will continue to provide the LHIN-funded hospital and community services currently delivered by their organizations. 4
Haliburton County Recommendations Voluntary merger between Community Care Haliburton County and Haliburton Highlands Health Services. One Entity to deliver hospice/palliative services currently provided by SIRCH and Adult Day Program services currently provide by VON. Accountability for coordinating Foot Care services would also be transferred from VON to the One Entity. SIRCH and VON would continue to exist as ongoing entities, with their own boards, programs and services but would no longer have an Accountability Agreement with the Central East LHIN. Volunteer Co-ordination SIRCH would investigate piloting a new model (Volunteer Match) that could be used by the One Entity in Haliburton County to recruit, screen, orient and train volunteers. 5
Current State Future State
Strategic Alliance between Ross Memorial Hospital and Haliburton Highlands Health Services Established to facilitate existing and future shared services opportunities, including: Laboratory Services Medical Device Reprocessing Medical Records Transcription Shared Information Technology Department Inventory Management System and Procurement Pharmacy Services Mental Health Leadership Cardiac Rehabilitation Diagnostic Imaging Management Document Management System for Policies and Procedures 7
Benefits of the One Entity in Haliburton County Local autonomy and local management over Haliburton County-specific services Potential cost savings for reinvestment Local residents would not have to go through as many doors and would have access to a broad range of services Streamlined volunteer opportunities for local residents who want to support their local health care organization More opportunities for staff in a larger organization One voice with an understanding of the health needs of the residents of Haliburton County to advocate for/apply for new funding 8
Transition Planning for Haliburton County Haliburton Kawartha Lakes Health Services Integration Plan was presented to the Central East LHIN Board for approval on December 18, 2013. The Central East LHIN Board approved the Integration Plan and requested a six-month status report on the implementation of the Plan. Discussions began between Community Care Haliburton County and HHHS related to their amalgamation in early January 2014, and more specifically about the governance structure for the amalgamated organization. A Transition Team, with executive representation from HHHS, CCHC, SIRCH and VON, was formed to begin planning for the implementation of the Integration Plan in Haliburton County. 9
Governance Plan Although the Integration Plan called for the formation of One Entity to provide health services within Haliburton County, discussions were initiated with CCHC and HHHS since the governance of only these organizations were to be impacted. The two Boards agreed that the proposed new One Entity would be HHHS and Community Care would wind-down as a corporation following the transfer of the community services on September 30, 2014. To facilitate the Governance Plan, vacancies on the HHHS Board would be held for CCHC Care Board members who wanted to move to the HHHS Board and would do so as of the HHHS Annual General Meeting on June 26 th, 2014. 10
Directional Plan The Transition Team developed a Directional Plan in March 2014 to establish broad business objectives and the general direction. The Directional Plan described the key Haliburton Countyspecific elements that were anticipated in the implementation of recommendations from the City of Kawartha Lakes/Haliburton County Health Services Integration Plan (December 2013) between the parties. The draft Directional Plan was presented to and approved by the HHHS, CCHC and SIRCH Boards and the Senior Leadership of the VON by March 30, 2014. The approved Directional Plan was forwarded to the Central East LHIN on April 2, 2014. 11
Transition Planning Activities The Transition Team documented key transition planning activities, timelines and milestones to ensure the timely completion of tasks, both to develop an Integration Transition Plan, and achieve the successful transition by September 30, 2014, including the following elements: Developing a communication and community engagement plan Determining the governance structures and processes, including developing a community advisory committee Developing a comprehensive human resources plan to transfer staff to HHHS and determine bargaining agent Outlining the process to transition clients and volunteers Drafting a post transition budget and financial plan to address onetime and ongoing expenses to deliver programs Determining facility requirements for programs and staff Addressing fundraising requirements for community programs in the future 12
Transition Plan The purpose of transition planning is to manage the change that needs to take place to successfully move a product or service from one state or environment to another state or environment. A Transition Plan traditionally identifies all of the key activities, key milestones, risks and mitigation strategies, costs, etc., that must be addressed for a successful transition. A documented Transition Plan is of value to the organizations (governors and staff) implementing the change and will assist them in planning for and managing the process. A documented Transition Plan will also demonstrate to key stakeholders (Central East LHIN, volunteers, funders, clients, donors, service partners, etc.) that the transition is being managed effectively and will be successful. In the context of the Haliburton County integration, transition planning refers to the process of transferring the accountability, funding and delivery of services between health service providers. 13
Haliburton County Health Services Integration Transition Plan Transition Team developed a Haliburton County Health Services Integration Transition Plan (the Transition Plan) to outline the necessary steps and supporting work that will need to happen over the next several months before the Haliburton County health services integration takes effect on September 30, 2014. Transition Plan was presented to and approved by the HHHS, CCHC and SIRCH Boards and the Senior Leadership of the VON by May 28, 2014. Approved Transition Plan was forwarded to the Central East LHIN on June 2, 2014 for consideration and final decisionmaking by the Central East LHIN Board of Directors. 14
Transition Plan Communication Upon approval of the Transition Plan, a roll-out of communication regarding the transition is planned. Meetings have been held with staff of CCHC, SIRCH, VON and HHHS to confirm that the Transition Plan had been approved by all the organizations. A Letter of Employment Intent was provided to all staff to demonstrate to each that there would be no job loss related to the integration (with a formal employment offer to be presented prior to September 30 th ). An email blast went out to all volunteers associated with the transferring programs to keep them informed. A press release and backgrounder was sent out to local Haliburton media and posted on all organizations websites to inform the community and public at large, as well as being sent to the Central East LHIN. 15
Transition Plan Next Steps Receive favourable consideration and approval of the Haliburton County Health Services Integration Plan from Central East LHIN Board Finalize financial plan (June) and submit to Central East LHIN (July) to determine post-transition budget for HHHS to operate transferred programs Continue to work with unions to finalize bargaining agent and negotiate new local agreement Continue to communicate with governors, staff, clients, volunteers and the community, along with Central East LHIN Successful integration transition on September 30, 2014 Celebrate transition and contributions of Community Care, SIRCH, and the VON for many years of providing community services to Haliburton County residents 16
Acquired Brian Injury Adult Day Service Integration Victorian Order of Nurses for Canada Ontario Branch (VON) Four County Brain Injury Association (FCBIA) operating under B.I.A.P.R.
Why? Central East LHIN initiated a Community Health Services integration strategy Integration Planning Team (IPT) (Haliburton and City of Kawartha Lakes (CKL)) reviewed services in those communities Acquired Brain Injury (ABI) Adult Day Program (ADP) is a highly specialized service IPT (Haliburton CKL) recognized the preference to retain this program with a local organization that has ABI expertise
Recommendation VON Acquired Brain Injury Adult Day Service transfer to Four Counties Brain Injury Association Benefits include: Continued delivery of current service volume Strengthening expertise in delivering specialized programs
What will remain the same? Service Funding Program Goals Current FCBIA Staff support maintained Hours of operation Client fee
What will change? Service provider VON FCBIA Service Location Mary Street William Street Terminology Day Program Day Service
Timeline Milestone Date Integration Plan Approved by CE LHIN December 2013 Transition Team Kick Off Meeting Terms of Reference Finalized February 28, 2014 April 24, 2014 Transition Plan Finalized June 9, 2014 Transition Plan Reviewed by CE LHIN June 25, 2014 Transition Date August 1, 2014
Community Care City of Kawartha Lakes- Victoria Order of Nurses (Adult Day Program)-Integration Update Kasia Luebke, System Design and Integration June 25 th, 2014
Background Beginning January 31st 2013, the health services providers in Haliburton County and the City of Kawartha Lakes met as part of the facilitated integration planning process. The outcome was the development of an integration plan which included the recommendation: In the City of Kawartha Lakes, Adult Day Services in Lindsay would be transferred from to Victoria Order of Nurses (VON) to Community Care City of Kawartha Lakes (CCCKL) Identified benefits of this integration include: Increase flexibility in programming of an Adult Day Services in a larger multi-service organization Streamlining the number of providers offering the same service Continued delivery of current service volume 27
Activities to date: A Transition Team has been established comprising of representatives from CCCKL and VON and the Central East LHIN. The Transition Team is working towards a seamless transition of the client service delivery process and drafting the transition plan. An in depth due diligence is being completed with respect to: impact on clients & caregivers human resources, including staff and volunteers and program logistics i.e. location. 28
Next Steps The goal is for Transition Plan to be brought forward to the September of 2014 Central East LHIN Board meeting. The plan will be implemented in the fall and winter months, with the target program transfer date of April 1, 2015. 29