4 A - Monthly CEO Report - South East Local Health Integration

Item 4 A
MEMO
To: SE LHIN Board of Directors
From: Paul Huras, CEO
Date: November 30, 2014
Re: Chief Executive Officer Monthly Report – Consent – November 2014
The CEO Report is split into two reports. One report is focused on updates and external and
internal engagement and is included in the Consent Agenda portion of the Board Agenda. The
other report is about items that could generate discussion among the Members.
Please note that in order to improve our flow of information to board members the
consent report will deal with information from the previous month only.
Attached to this memo are the following documents:
• Health Care Connect Update
A. Community Engagement
My community engagement activities for the previous month have included the following
meetings:
• Monday to Wednesday, November 03-05, 2014, I Travelled to Toronto to attend
the 2014 Health Achieve Conference.
• On Monday, November 03, 2014, I participated in the SECHEF Health Care
Tomorrow – Hospital Project - Project Management Office (PMO) meeting, via
teleconference where planned the agenda for the November SECHEF meeting.
• On Wednesday, November 05, 2014, while in Toronto, I met with Vania Sakelaris
re the Provincial Health Links working group meeting and the transition of Health
Links to LHINs.
• On Thursday, November 06, 2014, I participated in the CEO Council meeting, via
video Conference, where we discussed LHIN-Community Care Access Centre
(CCAC) Local Strategies, Tele-homecare program, Personal Support Worker
(PSW) Wage Enhancement, Provincial Standards Sustainability Office (PSSO)
Support for opening Intra-Facility beds, Ministry Management Committee (MMC) –
CEOs meeting, Aligning LHINs Integrated Health Service Plan (IHSP) with Ministry
Mandate, Shared Services Agreement (SAA), Realty Directive Policy, All SAA
Leads and Senior Director representation at future CEO Strategic Sessions.
• November 06, 2014, I participated in a teleconference call with Mary Kardos
Burton of The Association of Ontario Health Centres (AOHC) regarding the AOHC
Strategic Planning 2015/18.
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November 06, 2014, I participated in the Hospital Annual Planning Submissions
(HAPS) pre-launch/planning meeting, via teleconference, where we discussed the
agenda for the upcoming November 14th - 2015/16 Hospital Accountability
Planning Submissions: Education Session Webcast Event.
November 06, 2014, I travelled with Renee Oortwyn to Loyalist College in Belleville
where we were guest speakers for students in the Photo Journalism class. We
provided an overview of the LHINs and how they are accountable in Health Care.
On Friday, November 07, 2014, I participated in the “weekly” Project Management
Office (PMO) - Hospital Sustainability Team meeting, via teleconference, where we
discussed the overall project structure for the Health Care Tomorrow – Hospital
Project (HCT –HP).
November 07, 2014, I participated in the SECHEF meeting, via teleconference,
where we discussed the Data Analytics Plan – roles and expectations.
On Monday, November 10, 2014, I travelled to Kingston to attend the
Developmental Disabilities Consulting Program at Queen’s University regarding
the service needs in the South East Region.
November 10, 2014, while in Kingston, I was a guest speaker for the Fourth Year
Nursing students in the Management and Leadership class at Queen’s University.
November 10, 2014, while in Kingston, I met with Dean Reznick and Dr. Pichora
regarding the HCT-HP and the Academic community.
On Tuesday, November 11, 2014, I participated in the Health Care Access
Research and Developmental Dissabilities (H-CARDD) Local Advisory Committee
meeting, via teleconference, where we discussed the Town Halls Research
update, Applied Health Research questions research update, Annual Health Check
Study Research update, Emergency Care and Primary Care updates and
Knowledge Exchange.
November 11, 2014, I met with Kathryn Brohman, Associate Professor and
Distinguished Faculty Fellow in Information Systems – Queen’s School of Business, at
the Belleville office, where we discussed my upcoming video presentation to the
executive MBA classes across Canada to be held on Friday, November 14, 2014.
November 11, 2014, I travelled to Kingston, where I provided a Health Link
presentation to the Providence Care Board of Directors meeting.
On Wednesday, November 12, 2014, I attended the Collaborative Governance and
Community Engagement (CGCE) meeting, held in the Belleville office, where we
reviewed the 2014 Governance Workshops and Sector Representative Feedback
on Current Issues, including CGCE Committee vacancies.
November 12, 2014, I participated in a teleconference call with Brian Golden of the
Rotman School of Management regarding Health Links review.
November 12, 2014, I participated in a Pan-LHIN approach to Chronic Disease
Prevention and Management (CDPM) meeting, via teleconference, where we
discussed the Diabetes Coordination Function and related issues and next steps.
November 12, 2014, I attended the Transitional Alliance meeting, were I addressed
the issue of the role of the Academic Health Sciences centre in the Alliance.
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On Thursday, November 13, 2014, I participated in the CEO “Quick Call”, via
teleconference, where we discussed LHIN-CCAC Local Strategies, Personal
Support Worker (PSW) Wage Enhancement, Pan-LHIN Patient Experience
Survey, Ebola Command Table, Plans for Children with Special Needs, Ontario
Lab Services Advisory Forum – request for participation, LHIN Shared Services –
Time/Date for Decision and Community Funding – Targeted Mental Health and
Addictions Allocation.
On Friday, November 14, 2014, I participated in the “weekly” Project Management
Office (PMO) - Hospital Sustainability Team meeting, via teleconference, where we
discussed the overall project structure for the Hospital Sustainability.
November 14, 2014, I provided a presentation to the Queen’s Executive Master of
Business Administration (MBA) program classes across Canada, via video
conference, where my topic was System Leadership.
November 14, 2014, while in Toronto I Chaired the Hospital Annual Planning
Submissions (HAPS) Launch Webcast where there were discussions on the
Hospital Service Accountability Agreement (H-SAA) Organizational Structure,
Guiding Principles, HAPS Submission Timelines, Summary of Changes to
Guidelines and Draft Schedules for 2015/16 and Approach to Setting Planning
Targets.
On Monday, November 17, 2014, I met with Jacqueline Redmond, CEO of the
Community Care Access Centre (CCAC), in the Belleville office, where we
discussed challenges and opportunities at both organizations.
November 17, 2014, Donna Segal and I met with Margaret Werkhoven and Debbie
MacDonald Moynes, in the Belleville office, regarding Community Support
Services.
November 17, 2014, I met with Sherri Huckstep, Jo-Anne Poirier and Lori Cooper
of the Victorian Order of Nurses (VON), in the Belleville office, regarding VON
services.
November 17, 2014, I met with Mary Clare Egberts of Quinte Health Care (QHC),
in the Belleville office, where we discussed issues related to QHC.
On Tuesday, November 18, 2014, I participated in the Clinical Services Roadmap
(CSR) Executive Project Management Office (PMO) meeting, via teleconference,
regarding the Clinical Leadership Approach for the HCT-HP.
November 18, 2014, I travelled to Kingston where I was a guest speaker at the
South East LHINs Advanced System Leadership Program on the “View from the
Top Session”, where my topic was on the need for aspiring system leaders.
November 18, 2014, I participated in the Champlain LHIN Board to Board meeting,
via teleconference, where we discussed the Mental Health and Addictions
Redesign Project in the South East LHIN, Overview of the Hospital Sustainability
Project in the South East LHIN and Principles to guide Transformation Initiatives
that may have cross-LHIN implications.
November 18, 2014, while in Kingston, I met with Dr. Smith of Queen’s University
where we discussed Obstetrical and Gynaecological services in the SE.
November 18, 2014, I participated in a video/skype session with Dr. Tim Tenbensel
of Auckland, New Zealand and Dr. Mike Green of Queen’s University where we
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discussed the research opportunities with the Institute for Clinical Evaluative
Sciences (ICES) at Queen’s and Health Links.
On Wednesday, November 19, 2014, I travelled to Kingston, to attend the HCT-HP
portion of the SECHEF meeting.
November 19, 2014, while in Kingston, I participated in the South East Community
Care Access (CCAC) and Hospital Executive Forum (SECHEF) meeting, where we
discussed the Kingston Bariatric Surgery Program, Sustainability update, SECHEF
Regional Issues update, Non Urgent Transportation update, 2015/16 Preliminary
Budget Planning, Review of Clinical Plans to meet 2015/16 Budget Goals – KPMG
survey discussion, CSR-Preventing Patient Surge/Gridlock update, Convalescent
Care 6 month review, Addictions and Mental Health Redesign – Clinical
Implications, Ebola update and Quality Based Procedures (QPB) Volumes.
On Thursday, November 20, 2014, I participated in a teleconference call with Drew
Baillie, Mark Rochon and LHIN senior staff regarding HCT-HP.
November 20, 2014, I travelled to Toronto to attend the Health Quality
Transformation 2014 Event, where I attended various breakout sessions such as
“Judging Evidence: Finding a Place for Variation in an Evidence Based World” and
“Health Link Communities and Transformational Change – How Visionary
Leadership is Driving Health System Improvement”.
November 20, 2014, while in Toronto I also attended the Connecting Northern and
Eastern Ontario (cNEO) Executive Oversight Committee meeting, where we
discussed eHealth 2.0.
November 20, 2014, while in Toronto I met with Cathy Szabo, President and CEO
of Providence Care, where we discussed topics that were brought up at the
November 19th, 2014 SECHEF meeting.
On Friday, November 21, 2014, while in Toronto, I attended the Leadership
(CEO/Chair) Council “Face to Face” meeting, where there were discussions on the
Transformation Home and Community Care next steps, Collaborative Governance,
Debrief – conversation with Deputy Minister Dr. Bob Bell, Transformation Work
Group updates on LHIN 3.0, LHIN Regional Role in Health Links and Primary Care
Accountability.
November 21, 2014, while in Toronto, I attended the CEO Council “Face to Face”
meeting, where we discussed the 2014/15 Pan-LHIN Budget, PSW Wage
Enhancement, Shared Services Agreement, LHIN Legal Services, Francophone
Linguistic Variable, Shared Services, Transform the Patient Experience through a
Relentless Focus on Quality, Build and Foster Integrated Networks of Care, Tackle
Health Inequities by Focusing on Population Health, Ontario Hospital Association
(OHA)/ Ontario Medical Association (OMA) framework – redistribution of Hospital
Services and Quality Management Partnership.
On Monday, November 24, 2014, I participated in the Ministry of Health and Long
Term Care (MOHLTC) and fellow LHIN CEOs meeting, via teleconference,
regarding Scheduling Principles.
On Tuesday, November 25, 2014, I travelled to Kingston to attend the
Sustainability Clinical Direction Setting Session, where we discussed Framework
and Objectives, Urgent/Emergent, Chronic/Frail Elderly and Clinical Leads.
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November 25, 2014, I participated in a teleconference call with Dr. Jonathan Kerr
regarding Health Links.
On Wednesday, November 26, 2014, Donna and I met with Mary Clare Egberts,
Steve Blakely and Tricia Anderson of Quinte Health Care, in the Belleville office,
QHC funding pressures.
Thursday, November 27, 2014, I participated in the CEO “Quick Call”, via
teleconference, where we discussed LHIN-CCAC Local Strategies, PSW Wage
Enhancement, the Ebola Command Table, Legal matter, Special Needs Strategy
and eConsultation.
November 27, 2014, I travelled to Kingston to attend the Pan-LHIN Education
Session: Collaborative Governance meeting, where we discussed the LHIN
perspective, Provider perspective and LHIN experience with Collaborative
Governance: North Simcoe Muskoka LHIN experience.
On Friday, November 28, 2014, I participated in the “weekly” Project Management
Office (PMO) – HCT-HP Team meeting, via teleconference, where we discussed
the overall project structure for the Hospital Sustainability.
November 28, 2014, I participated in the Health Links panel discussion, via
teleconference.
November 28, 2014, I met with Betsy Sinclair and George MacNabb of Patients of
our County Hospital (POOCH), in the Belleville office, regarding Prince Edward
County Memorial Hospital.
November 28, 2014, I travelled to Brighton where I met with MPP Lou Rinaldi local
health care pressures.
B. Media Activity:
News Media Activity
During the month of November 2014, I was contacted by CKWS TV journalist Meagen
Kulchar regarding Kingston General Hospital and the high wait times. After this the South East
LHIN received three media calls, the first two from radio station Mix’97 on Hospital Funding
and on the Home and Community Care announcement. The third call came from radio station
Classic Hits 95.5 on the Low Back Announcement. The Home and Community Care
announcement was also picked up by our local papers.
On November 6 Renee and I had the opportunity to visits potential future journalist while
presenting at the Radio Journalist class at Loyalist College in Belleville. We spoke about how
the different layers of government work together and what LHINs do for people within our
community.
Social Media Activity
The South East LHIN Facebook page made seven posts during the month of November and
the amount of ‘Likes’ stayed at 255. The Twitter page engaged with our followers this month
by tweeting a total of five times and the followers went from 1,759 to 1769.
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C. Provincial Projects and Priorities:
Health Links (Incl. Advisory Table)
This group last met on Wednesday, November 05, 2014 in Toronto, where we
discussed/reviewed the Advanced Health Link Model approach: Gaps, Roles and Next steps.
Primary Care Expert Committee
This group last met in September, 2014, in Toronto.
D. Provincial Committees and Work Groups:
Ministry Management Committee (MMC) /LHIN CEOsThis group last met on Tuesday, October 07, 2014, via teleconference.
E. LHIN Leadership Council Committees and Work Groups:
H-SAA Steering Committee
The H-SAA LHIN Co-Chairs last met on Wednesday, November 26, 2014, via
teleconference, where we discussed the Hospital Annual Planning Submissions (HAPS),
Communique issued to the Hospital Sector , HAPS Launch on November 14th, 2014
update, H-SAA Indicators Work Group update, Committee’s Endorsement of 2015/16
H-SAA Indicators and Next steps.
Transformation Work Group – Lead
This group last met on Wednesday, November 05, 2014 in Toronto where we discussed
the Invitation to Gail Donner - Home and Community Care Expert Group update/next
steps, LHIN 3.0 – review of the draft and next steps, Primary Care update and Health links
update.
LHSIA Work Group
This group last met on Friday, April 04, 2014.
F. New LHIN Staff:
Lisa Anne Chatten has joined the SE LHIN Knowledge Management Team in November,
2014. She brings with her an extensive background in communications, administration, and
promotions, having worked with several non-profit agencies and charities throughout the
community. She currently sits as a Director on two Governance Boards; Canadian Mental
Health Association and Quinte Crime Stoppers.
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She has significant involvement in several current fundraisers, including The Firefighter Toy
Drive, Canadian Cancer Society, Wheelchair of Hope Foundation, and The Hospital
Foundation. She also assists families beginning on a journey of Autism, helping them in taking
their first difficult "diagnostic path" steps forward, directing them to valuable community
resources, and advising families of available funding opportunities through her project,
Attachment Autism.
She is excited to be a part of this dynamic and interactive team, and looks forward to the
opportunities and projects within the SE LHIN Knowledge Management team over the next
several months.
G. OPSEU BLOG
Subject: OPSEU opinion column SELHIN
Importance: High
This is a good piece that came out of a meeting Jennifer and Paul had yesterday with OPSEU representatives.
Relationship building with the LHINs
Posted on December 4, 2014 | Leave a comment
Health care providers have found religion when it comes to involving patients in the planning and
decision-making process. At this year’s OHA HealthAchieve every administrator was quick to extol
the virtues of soliciting community participation.
In a meeting in Belleville yesterday, Paul Huras, CEO of the South East Local Health Integration
Network, told us they constantly review new proposals from a patient perspective.
That, after all, is what this is all about.
LHINs are also subject to a parade of presentations by health care administrators that tend to gloss
over the problems and highlight the progress, unless the problems are leading to a specific ask. Let’s
face it, who wouldn’t want to look as competent as possible before the funding body they report to?
That does mean, however, the LHINs are not always seeing the complete picture, especially the many
realities not captured by scorecard data.
Contrary to former Ontario PC Leader Tim Hudak’s wild assertions about the LHINs being some huge
bureaucracy, the reality is they are tasked with a big job and very little in the way of resources. We all
want accountability, transparency, community consultation and responsive regional planning — the
question is, how much are we willing to pay to get it? Last year Huras’ LHIN transferred a little more
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than $1 billion to provide health services in his region – about two-thirds of that going to hospitals.
The amount Huras has to run his own administrative shop? In 2012-13 it was about $4.6 million – a
drop of about $200,000 from the previous year. The LHINs have not been immune to government
austerity.
Our meeting with Huras was the second around a proposed redesign of mental health services within
the SE LHIN. In addition to OPSEU staff, there were front line representatives from Providence Care,
Hotel Dieu Hospital and Frontenac Community Mental Health and Addiction Services.
Huras prefaced the meeting by suggesting the redesign would produce very little change for front line
staff – his expectation was there would be no job loss beyond potentially a handful of duplicate
administrative positions. He told us mental health is a priority and the expectation is that services
would expand, not contract.
There is always some anxiety about jobs when change is in the air, but we didn’t leave after that
assurance.
The people who work directly with patients on a day-to-day basis are deeply motivated to see the best
outcomes. It’s not an abstract exercise when you’ve been to the patient’s house, seen his or her family,
and the patient knows you by your first name.
There is deep frustration, particularly around mental health, that increased demand and rising acuity is
not being met with appropriate funding from Queen’s Park. Ontario’s lengthy austerity may be
connected to both cause and effect. To compound this, one of the consequences of the present
campaign around stigma is that more individuals are likely to come forward for treatment. The
question is, what will they find when they do take that important first step?
That frustration is certainly not news to Huras. The question is, how can we all work together to do the
best we can? Huras has to work with what he has been given and discretionary funding at the LHIN
level is extremely limited.
Involving labour is not always easy. We can still recall one hospital CEO being furious with us
because of a letter we sent to a regional LHIN. Even though the issue was on the LHIN’s agenda, the
suggestion was our relationship with that LHIN constituted going over her head.
In Thunder Bay we organized a facilitated discussion on mental health services with front line
providers and the North West LHIN in 2012. While we cautioned the workers about revealing
identifying details about their patients, we also asked that none of the names of the participants be
made public to protect the workers from potentially upset employers.
The LHINs have to be cognizant that they are seeking input from a stakeholder community that feels
largely restrained about what they can openly say. There is always fear of reprisal. That restraint
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certainly goes beyond front line workers. Huras reminds us that the LHIN itself is a Crown
corporation. He doesn’t need to say more to let us know that he himself has limits to what he can
publicly say.
For a system where people talk a lot about the importance of openness and transparency, the reality is
very few of us are in a position to really do that.
Yet the perspective of the people who directly work with patients is valuable. The NW LHIN took
copious notes during our roundtable in Thunder Bay. We were proud of our members who were
remarkably articulate, showed a willingness to be constructive, generated good ideas, and were clear
about the consequences of the missteps they have witnessed. Given the average hospital CEO serves
in their position for about five years, the staff at these provider organizations often have more
institutional memory than the people who authorize their paycheques. They should be listened to.
There is another reason why government and the LHINs should be seeking the perspective of
organized labour: the encounter works both ways. We want to be understood, but so do the LHINs and
others who are drafting public policy.
During yesterday’s meeting we expressed concerns about parts of the mental health redesign that
involved the merging of provider organizations. Such mergers seldom save money, and in a flatlined
environment for base costs, we warned that such costs could have a negative impact on staffing and
workload.
We also highlighted other concerns expressed by front line staff, including anxiety that catchment
areas could expand for community workers, leaving them to spend more time on travel and less on
client care. The contracting model also made us nervous, especially given our direct experience in
home care.
Given the lack of detail behind many facets of the redesign plan, we asked about future opportunities
to respond once the details were known.
Hy Eliasoph, the first CEO at the Central LHIN, once brought us together to chat about expectations.
He said he wanted us to get to know one another, because when we found ourselves in conflict over a
decision before the LHIN, we’d at least have built relationships where we felt we could pick up the
phone and talk to each other.
With some LHINs we are already at that stage. At others we haven’t even started.
Dave Lundy, OPSEU’s Vice-President in the region that overlaps the South East LHIN, suggested to
Huras that we get together and have these conversations quarterly. Huras agreed.
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Huras said that during the LHIN hearings in the spring he heard about how the SE LHIN was not
consulting labour, but said it was a two-way street. Labour wasn’t approaching the SE LHIN either.
We spoke about our relationship with other LHINs and how that worked.
At one point we did try to establish a labour panel in the Central East LHIN, but sad to say, there was
considerable reluctance on the part of front line workers to fill such a panel for many of the same
reasons we listed above.
None of this is easy. In the South East LHIN we have found a way to start talking.
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