central east ccac board agenda -...

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Central East CCAC Board Agenda

Date: Wednesday, May 11, 2016 Place: Central East CCAC, Whitby Branch, Durham Room

Time: 6:30 p.m. Teleconference Line: 1 866 232 9443 Participant Passcode: 2578505#

Agenda Item

Action Required

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1. Introductory Items

1.1. Call to Order L. Lifchus

1.2. Confirmation of Quorum L. Lifchus

1.3. Approval of Meeting Agenda X X L. Lifchus

1.4. Declaration of Conflict L. Lifchus

2. Central East CCAC Transition update X K. Ramsay

3. Board Education/ Generative Discussion Vl-1

3.1. Patient Story X K. Ramsay

3.2. Personal Support, Adult Therapy and School

Waitlist Trends

X X X L. Burden

4. Minutes of Previous Meeting, Action Items and

Business Arising

4.1. April 13, 2016 Board Meeting Minutes, In-

Camera Minutes and Action Items

X X L. Lifchus

5. Reports

5.1. CEO Report to the Board X X K. Ramsay

5.2. PQE Committee (draft Minutes) X Part III X N. Crow

5.3. Finance Committee Part IV X P. Connolly

5.4. Audit Committee Part IV X R. Morphew

5.5. Governance Committee Part V X G. Lounsbury

5.6. Report of the Chair Part V X L. Lifchus

5.7. OACCAC Report

Vl-4 X L. Lifchus

Persons who need accommodation and those needing an alternative format of meeting material,

may email a request to the meeting coordinator.

The Central East CCAC is a scent-free workplace. Please refrain from wearing scented products. Thank you.

Agenda Item

Action Required

Presenter

Att

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Policy

Refe

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Info

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Monitoring

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6. New Business

7. Correspondence X K. Ramsay

9. Adjournment X L. Lifchus

Central East Community Care Access Centre

Outstanding careevery person

every day

Board of Directors Meeting

May 11, 2016

Presentation Objectives

Review of Personal Support, Adult Therapy and School Waitlist Trends

Criteria for Personal Support and Adult Therapy

Demonstrate Demand for Service

Financial Impact

Next Steps in waitlist management

Central East CCAC

PSW Waitlist March 2014 –February 2016

Central East CCAC

*September 1st- new Personal Support and Adult Therapy

Criteria initiated

0

500

1000

1500

2000

2500

Patients

Personal Support & Homemaking

Personal

Support &

Homemaking

Personal Support Waitlist as of March 14, 2016

Central East CCAC

RAI 1-7

RAI 8-12

RAI 13-15

RAI 16+

Awaiting Updated

Assessment

All

Personal Support Waitlist

Number of

Patients

132 870 639 248 428 2317

Personal Support

Enhanced Waitlist *

Number of

Patients

12 235 343 369 97 1056

*Patients already receiving personal support and reassessed to require additional services

Enhanced and Regular PSW Waitlistby RAI as of March 14, 2016

Central East CCAC

0

50

100

150

200

250

300

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 27

Number of Patients

RAI score

Regular and Enhanced PSW Waitlist-RAI

Enhanced

Regular

Enhanced and Regular PSW Waitlistby MAPLe as of March 14, 2016

Central East CCAC

0

100

200

300

400

500

600

700

800

900

Low Mild Moderate High Very High

Number of Patients

MAPLe Scores

Enhanced and Regular Waitlist-MAPLe

Enhanced

Regular

Central East CCAC

Personal Support Hours and Cost

Waitlist March 2014 –February 2016

Central East CCAC

* September 1st-new Personal Support and Adult

Therapy Criteria initiated

0

500

1000

1500

2000

2500

PSW, OT, PT Waitlist March 2014 -February 2016

Occupational Therapy

Personal Support &Homemaking

Physiotherapy

Central East CCAC

Physiotherapy Visits and Cost

Central East CCAC

Occupational Therapy Visits and Cost

Central East CCAC

Patient Profiles by RAI Grouping

RAI Grouping Patient Profile

RAI 1-7 • Patient may have 1 or more health or chronic conditions.

• Patient is capable of living independently and has a stable support network.

• Focus is on increasing independence.

• Patient will be linked to community resources and support agencies such as Meals on Wheels, Transportation, Adult Day Programs, Friendly Visitors

• Delay in PSW initiation- Low Risk

Case Scenarios- Community Independence

• 67 year old male admitted to hospital diagnosed with stroke

• Right side weakness and requires assist x 1 for transfers and all ADLs

• Lives with spouse and adult children who are able to provide supervision and support for patient

• Requires use of wheelchair for independent mobility as well as bed rail for home

• Patient has made good gains in rehab however continues to have some cognitive deficits and will need daily support with all ADLs and IADLs

• Patient and family are cautiously optimistic that with continued therapy and support at home, patient will regain most of his independence

Central East CCAC



RAI 8-12 • Patient has 1 or more health or chronic conditions and may have complicating factors.

• Direct care needs are stable or can achieve stability with support network.

• Requires assistance with IADLs/ADLs to keep patient at home.

• Focus of intervention is to help patient manage at home and prevent further decline.

• Patient will be linked with community resources and support agencies.

• Delay in PSW initiation- at some risk for increased deterioration.

Central East CCAC



RAI 13-15 • Patient is similar to previous profile- 1 or more healthor chronic conditions with possibility of complications.

• Decreased ability to access the community and more reliance on care providers for IADLs and ADLs.

• Delay in PSW initiation- higher Risk of decline and inability to remain at home, especially if not intact cognitively and/or behaviours exist.

Case Scenarios- Chronic• 80 year old with dementia, history of depression and anxiety

• Lives with family (spouse, son, DIL, 2 grandchildren - grandson has medical needs that put more strain on son and DIL)

• DIL is primary caregiver and is assisting in showers, hair washing/brushing, toileting, incontinence BID

• Patient is able to manage basic hygiene family manages all IADLs, spouse provides meds –includes antipsychotic med d/t psychotic episode 2011

• Ambulates without aids indoors, mobility is slow and balance unreliable, one person assist when out – refuses cane

• Generally cooperative, occasionally resistive to changing clothes

• Recent increase in confusion, loss of interest, sleeps/lays down all day

• Had fall in washroom 1 month ago, sustained backache

• Family declined LTC application at this time

• Spouse is elderly but is able to assist/supervise when family are at work

• Requires OT and PSW

Central East CCAC



RAI 16+ • Patient has 1 or more health or chronic conditions with complicating factors.

• Direct care needs are not stable and unpredictable.

• Support network may not be sufficient.

• Will require an array of services and coordination to manage care and to remain at home.

• Delay in PSW initiation- at High Risk for further decline and inability to remain at home safely.

Case Scenarios- Complex

• 90 year old patient who lives with spouse who also has multiple care needs in basement of son’s home

• Diagnoses of dementia, diabetes, renal insufficiency, hypertension, asthma

• Total dependence for all Activities of Daily Living and Instrumental Activities of Daily Living

• Total Assistance required for locomotion

• Severe cognitive issues including memory loss and behaviours

• Incapable of making own personal care decisions

• Resists care

• English is not first language

• Son will not provide support as per cultural beliefs

• Two daughters assist both parents with care but are feeling burnout

• Currently not interested in LTC as per cultural beliefs

• Receiving PSW and OT from CCAC

Personal Support/Adult Therapy Waitlist Guidelines- Snapshot

Central East CCAC

Waitlist Activities Personal Support

July 2014

Communication to Care Coordinators regarding providing Personal Support Services to patients with a RAI score of 16+ and Very High MAPLe.

September 2015

New Waitlist Criteria implemented for Personal Support Services including moving the RAI score to 17+ and Very High MAPLe for patients to receive service in order to optimize resources- allowing for the CECCAC to continue providing service to the most at risk and vulnerable patients.

Refresh of the scores and algorithms available in the RAI suite of tools and the Client Care Model populations to guide waitlisting activities

Reminder to all Care Coordinators of the Patient Contact Guidelines and Reassessment Guidelines for patients that are waiting for service

Central East CCAC

Waitlist Activities Adult Therapy

September 2015- initiation of new Waitlist Criteria for Adult Therapy-Physiotherapy, Occupational Therapy, Speech Language Therapy, Social Work, Nutrition

Refresh of the eligibility guidelines for CCAC services to all staff including the definition of “access the community”

Use of the scores and algorithms available in the RAI suite of tools to create waitlist criteria and to ensure that high care needs patients are receiving services

Central East CCAC

SSHS Waitlist March 2014 – February 2016

Central East CCAC

0

500

1000

1500

2000

2500

3000

3500

31

-Mar

-20

14

30

-Ap

r-2

01

4

31

-May

-20

14

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n-2

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4

31

-Ju

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4

31

-Au

g-2

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4

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p-2

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4

31

-Oct

-20

14

30

-No

v-2

01

4

31

-De

c-2

01

4

31

-Jan

-20

15

28

-Fe

b-2

01

5

31

-Mar

-20

15

31

-May

-20

15

30

-Ju

n-2

01

5

31

-Ju

l-2

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5

31

-Au

g-2

01

5

30

-Se

p-2

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5

31

-Oct

-20

15

30

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v-2

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5

31

-De

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-20

16

29

-Fe

b-2

01

6

Number of Students

Date

SHSS Waitlist March 2014 to February 2016

Occupational Therapy

Physiotherapy

Speech/Language Pathology

SSHS Waitlist

Occupational Therapy had 2026 students taken off the waitlist between April 1, 2014 and March 31, 2015.

On average those students were on the waitlist for 423 days.

Speech Language Therapy had 2127 students taken off the waitlist between April 1, 2014 and March 31, 2015.

On average those students were on the waitlist for 762 days.

Central East CCAC

SSHS Waitlist- Occupational Therapy

Priority of service for Occupational Therapy is determined by the students ability to safely access the school curriculum.

Short Term/Acute (Very High):

A specific functional problem requiring focused, short term intervention

Accessibility/safety within the school i.e. seating/ positioning, adaptations, classroom/bathroom renovations, ramping, modifications to work station, etc.

Complex (High):

Experiencing difficulties with communication and/or technology, Sensory Processing and performance of Self Care/ADL skills; may accompany Fine Motor deficits

Have a highly changeable health status and unpredictable outcome

Noticeable Progressive decline in functioning

Cannot participate in classroom or home routines

Decreased organization skills & motor planning

Oral motor/feeding/diet concerns

Change in school support

Central East CCAC

SSHS Waitlist –Occupational Therapy continued

Chronic (High):

Experiencing difficulties with communication and/or technology, Sensory Processing and performance of Self Care Activities/ADL skills; may accompany Fine Motor deficits

Ongoing equipment to maintain function

Intermittent difficulties associated with growth

Modification to school/classroom

Change in school support

Fine Motor (Moderate to Low):

Written productivity issues

Fine motor delays associated with weak written communication skills, poor classroom productivity

May require equipment to optimize function

Unable to keep up with peers despite normal intelligence

Central East CCAC

SSHS Waitlist –Speech Language Therapy

Service priority for articulation, motor speech disorders/dyspraxia, fluency, voice and/or complex language disorders is determined by the degree of impact on the following components of speech:

Intelligibility

Stimulability

Muscle weakness/coordination of muscles

Interruption in smooth easy flow of speech

Abnormalities in pitch/tone, quality or resonance

Physical, cognitive or neurological impairments which contribute toward a reduced rate of progress

Central East CCAC

Next Steps

CECCAC will continue to monitor and balance the demand for services with financial resources

The focus of service provision will remain on those patients that are most complex and vulnerable

Continue to monitor spend at weekly OBRAM meetings and adjust OBRAM allocations accordingly

Central East CCAC

Central East CCAC Board Meeting – April 13, 2016 Page 1 of 6

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE

BOARD MEETING

MINUTES

Date: April 13, 2016

Time: 6:30 pm

Present: Len Lifchus (Chair), Kathryn Ramsay (CEO), Gary Lounsbury,

Carmen Rapati, Patrick Connolly, Michelle Rawnsley, Susan Donaldson, Glenn Rogers, and Andy Williams

Teleconference: Nicola Crow

Regrets: Sylvia Patterson, Rick Morphew and Derrick McLennon

Guests: Lisa Burden, Michelle Nurse, David Stringer and Meera Balasubramaniam

Recorder: Robin Russell

1.0 Introductory Items

1.1 Call to Order

The meeting to order at 6:34p.m.

The Chair welcomed Kathy Ramsay to her first meeting as CEO,

congratulated board member Carmen Rapati (nee Nisbet) on her recent

marriage and introduced Meera Balasubramaniam, a University of

Toronto Masters Student currently interning with the Central East CCAC.

1.2 Quorum

A quorum was present


1.3 Approval of Meeting Agenda

MOTION: TO APPROVE THE AGENDA OF APRIL 13, 2016, WITH

THE ADDITION OF AGENDA ITEM 8 - IN-CAMERA

SESSION.

MOVED: Glenn Rogers

SECOND: Susan Donaldson CARRIED

1.4 Declaration of Conflict (Policy Reference V-A-3)

No conflicts were declared.

2.0 Central East CCAC Transition Update

Senior Team members led a discussion regarding the ongoing transition of the

CCACs, as per the Patients First discussion paper. It was noted that Deputy

Minister of Health, Dr. Bob Bell and Associate Deputy Minister Nancy Naylor

met with the CCAC CEOs to provide an update on the CCAC transition. CEOs

were advised that work is underway on the required legislation and that the

Ministry of Health and Long-Term Care anticipates a first reading of the

amended legislation during the spring 2016 session.

It was noted that correspondence was received from Minister of Health Dr. Eric

Hoskins, in follow up to correspondence from Deputy Minister Dr. Bob Bell,

regarding CCAC compensation and benefit provisions. It was noted that the

Central East CCAC is in compliance.

3.0 Board Education / Generative Discussion

3.1 OACCAC Governance

It was advised that the Board of the OACACC was considering its

governance options as a result of the Patients First: A Proposal to

Strengthen Patient-Centred Health Care in Ontario discussion paper

4.0 Minutes of Previous Meeting, Action Items and Business Arising

4.1 March 9, 2016 Board Meeting Minutes and Action Items

The Minutes and Action items for the March 9, 2016 Board Meeting were

reviewed with no changes noted.


MOTION: TO APPROVE THE MARCH 9, 2016 BOARD MEETING

MINUTES AND ACTION ITEMS

MOVED: Andy Williams

SECOND: Patrick Connolly CARRIED

5.0 Reports

5.1 CEO Report to the Board

The April, 2016 CEO Report to the Board was presented, as circulated.

It was noted that the annual Public Salary Disclosure list had been

published. Board members were advised that the Central East CCAC

increase from 2014 reflected the labour disruption experience in

February, 2015, as well as an extra pay period in 2015.

Board members were apprised that the Ontario Auditor’s Report

recommendations were being addressed by the sector through the

OACCAC and it was noted that work was underway. The audited CCACs

as well as the OACCAC has been requested to present to Public Accounts

on May 11, 2016 It was noted that the CECCAC would continue to move

forward locally and provincially to meet the deadlines.

Board members requested clarification on the report on Nurse

Practitioners Supporting Teams and Averting Transfers (NPSTAT) and

requested clarification on how the “days saved” metric is quantified.

ACTION: L. Burden to provide Robin Russell with the formula

used to quantifying days saved, to be sent to Board

Members as information.

Board member acknowledged the great work on falls prevention

program.

5.2 PQE Committee

The PQE Committee minutes were presented, as circulated. It was

noted that a presentation on Personal Support, Adult Therapy and

School waitlists was provided at the April Committee meeting. The

presentation, which addressed the challenges of growth in waitlist,

complexity and need, will be provided to the Board at the May Board

meeting


It was noted that the most recent Patient Caregiver evaluations results

were reviewed and the Central East CCAC is on par with provincial

average. It was noted that this data is delayed six (6) months and

processes are put in place to improve metrics before results are

received.

5.3 Finance Committee

The Finance Committee Minutes were presented, as circulated, and it

was noted that as of the most recent Committee meeting there was a

projected budget deficit but that the Committee was optimistic that the

budget would balance as numbers were finalized. It was noted that the

salary line had been finalized and a savings of $900,000 was realized

due to a hiring freeze in non-patient services and management,

increased vacation day utilization and consistent allotment of contracted

services such as Health Links to the correct budget line. It was further

noted that the majority of lease renewals have been completed.

5.4 Audit Committee

It was advised that the Auditors for the Central East CCAC will begin the

annual audit on May 9, 2016. The Audit Committee will convene a special

meeting in advance of the PQE Committee meeting on May 11, 2016 to

review the draft audited statements.

5.5 Governance Committee

It was noted that the Nomination Committee had spoken with all eligible

Board Members and advised that all agreed to continue their service

with the Board during the transition period. It was noted that that the

Governance Committee next meets May 11, 2016.

5.6 Report of the Chair

Board members were reminded of the special joint meeting to be held

with the LHIN Board of Directors at the CCAC Whitby Branch on May 25,

2016. It was noted that Senior Team and the Central East CCAC CEO

will provide the LHIN Board with a CCAC overview.

ACTION: R. Russell to send invitations to Board Members once

details are finalized


It was advised that CEO succession plan has been completed for 2016-

2017. (Policy Reference II-7)

It was noted that the annual board surveys, Board Member Self-

Evaluations and Committee Evaluations have been completed and the

Governance Committee will review the results in the coming month.

(Policy Reference V-B-8)

ACTION: R. Russell to send Board members details on how to

complete surveys not yet submitted

It was noted that the Board Chairs Council met on April 4, 2016 and L.

Lifchus agreed to sit on a committee for the OACCAC Conference for

LHIN Board members attending the OACCAC Conference. It was also

noted that G. Lounsbury would be attending the Governance Advisory

Council’s Governors’ Forum on behalf of the Board.

5.7 OACCAC Report

No report.

It was decided that the OACCAC Report would be removed as a standing

agenda item, as the Central East CCAC no longer has a representative

on the OACCAC Board.

MOTION: TO ACCEPT REPORTS FOR ITEMS 5.1-5.7, AS

INFORMATION

MOVED: Patrick Connolly

SECOND: Michelle Rawnsley CARRIED

6.0 New Business

No new business

7.0 Correspondence

It was noted that the Board Chair was copied on a letter sent from the

Township of Scugog to the Minister of Health, in response to the Patient

First discussion paper, requesting inclusion in the consultation process.


8.0 In Camera

MOTION: TO MOVE OUT OF THE REGULAR BOARD MEETING AND IN

TO THE IN CAMERA PORTION OF THE MEETING (PER

POLICY V-B-7 FOR MATTERS RELATED TO PERSONNEL) AT

7:15 P.M.

MOVED: Susan Donaldson

SECOND: Michelle Rawnsley CARRIED

MOTION: TO MOVE OUT OF IN CAMERA AT 7:48 PM

MOVED: Carmen Rapati

SECOND: Nicola Crow CARRIED

MOVE OUT OF IN CAMERA

9.0 Report of Actions taken In-Camera

Board Members moved to support the OACCAC Membership Agreement and

By-law proposal.

ACTION: Robin Russell to send Board Members information on process for

candidate nomination for the OACCAC Board.

10.0 Adjournment of meeting

MOTION: TO ADJOURN MEETING AT 8:20 P.M.

MOVED: Glen Rogers CARRIED

Len Lifchus, Chair Date

ACTION ITEMS FROM

APRIL 11, 2016

BOARD MEETING

Action Item

Responsibility Time Line Status

1. L. Burden to provide Robin Russell with

the formula used to quantifying days saved, to be sent to Board Members as information.

L. Burden /

R. Russell May 11, 2016 Complete

2. R. Russell to send invitations to Board

Members for May 25, 2016 meeting with

Central East LHIN Board once details are

finalized

R. Russell May 25, 2016

Complete

(location to be confirmed)

3. R. Russell to send Board members details

on how to complete surveys not yet submitted


4. Robin Russell to send Board Members

information on process for candidate nomination for the OACCAC Board.


May 2016 Page 1 of 13

The Central East CCAC

CEO Report to the Board May, 2016

Outstanding Care Partner

Engage with clients, caregivers and partners to coordinate quality home and community care that promotes safe independence, drives optimal health outcomes and delivers a positive experience.

School Health Support Services – Special Equipment Pilot

Upon review of the Occupational Therapy Waitlist for School Health Support services, it was

identified that a number of students who will be transitioning to high school in September

require an assessment for technology support, i.e. laptop/iPad. Students requiring technology

support in the school setting require an application to be submitted to the school board Special

Equipment Amount (SEA) department, accompanied by a letter of recommendation for the

equipment from an Occupational Therapist. These children are normally ranked low in priority

as their needs fall under fine motor skills, which are considered low risk from a functional

perspective however delaying access to technological equipment results in an increased risk

due to their inability to fully participate in learning activities where technology would be

otherwise utilized.

As part of a trial process developed with our Service Provider and School Boards, a total of

additional 66 students throughout the Central East CCAC were removed from the Occupational

Therapist (OT) waitlist in April, 2016. It is important to note that the funding for this has been

allocated from the existing School Health visits volume allocation.

The Occupational Therapist will determine the technology need and provide a recommendation

letter for the equipment as required by the school boards to ensure that these students will be

equipped with the necessary technology support required to assist them to be successful at

school. Two OT visits per student were authorized. Deadlines for SEA applications vary in the

Durham, Kawartha Pine Ridge, Peterborough Victoria Northumberland Clarington and Toronto

school boards; however, by the end of the current school year, each student will be assessed

by an OT and a recommendation letter for the equipment will be provided to the school for each

student.

Outstanding Care Partner Outstanding System Partner Outstanding Place to Work

Strategic Goals

Optimize Health Outcomes ☒ Balance Our Budget

☐ Develop Our People ☐

Provide Comprehensive System Navigation

☐ Collaborate with our

Community Partners Services

☐ Provide Healthy Safe

Workplaces

☐

Design Patient-Centric Programs

☒ Deliver High Value, Outcome-

based Care

☒ Support Flexible Work

Environments

☐

Promote Safe Independence ☐ Expand Partnerships

☐ Be an Innovative Learning Organization

☐ Ensure Quality and Safety

☐ Enable Service Excellence ☐


Wound Care Committee Update: Total Contact Casting

The Central East CCAC Wound Care Committee (WCC) consists of Program Directors, Senior

Managers, Operations Managers and Care Coordinators from Patient Services, as well as

representatives from the Contracts Team and Nursing Service Provider Partners. The mandate

of the Committee is to review wound care best practices and to implement quality

improvements to achieve best practice.

Over the past year, the WCC has been reviewing the implementation and sustainability of the

organization’s wound care pathways, monitoring their effectiveness and assessing the need for

improvement. In support of continuous improvement, representatives from the committee

attended a two-day conference on October 28, 2015 in Toronto hosted by the Canadian

Association of Wound Care. Total Contact Casting was presented at this conference and

promises to be a remarkable and effective method of wound care for treating diabetic foot

ulcers.

Following the Canadian Association of Wound Care Conference, the WCC invited a wound care

specialist to review the treatment of diabetic foot ulcers using the product Total Contact Casting.

This expert noted that Total Contact Casting causes remarkable wound healing, decreased

nursing visits and most importantly improved quality of life for individuals who have dealt with

poor healing diabetic ulcers for up to 4 years.

In February 2016, Care Partners, one of our Nursing Provider Partners, was provided with

complimentary Total Contact Casting products from BSN medical. Three long-term Central East

CCAC patients with diabetic foot ulcers were selected. After only 8 weeks utilizing Total Contact

Casting, remarkable healing was observed, and additionally resulted in one of these patients

being discharged.

The cost analysis indicated that the predicted total cost savings per patient utilizing the Total

Contact Casting is $1701.11 vs. our current wound care approaches. Notably, the savings is

realized entirely by the reduction in length of stay and nursing visits, which dramatically

decreased from over 120 days to 56 days. This is the desired outcome for both the patient and

the Central East CCAC.

Over the next few weeks, processes will be developed with an anticipated GO Live date of June

30, 2016.


Strategic Goals







Workplaces

☐


☐ Deliver High Value, Outcome-

based Care

☒ Support Flexible Work

Environments

☐

Promote Safe Independence ☒ Expand Partnerships


☒ Ensure Quality and Safety

☒ Enable Service Excellence ☐


Outstanding System Partner

Actively contribute to an integrated and sustainable health system by expanding partnerships,

embracing leading practices and innovation and achieving value for money.

Central East LHIN Self-Management Program

The Self-Management Program currently receives its funding through the Central East LHIN and

the Ministry of Health and Long Term Care (MOHTLC) as part of the Ontario Diabetes Strategy.

The MOHLTC recently announced that it will be divesting the 14 Self-Management Programs

from the MOHLTC and transitioning them to their respective LHIN, by July 1, 2016. The Ministry

has been transitioning Diabetes programs to the LHIN since 2013, starting with the Diabetes

Education Programs. In addition to the Self-Management Program, the Centres for Complex

Diabetes Care (CCDC) will also be divested. The MOHLTC has confirmed that programming will

not be interrupted during this transition.

In Central East, the Central East LHIN Self-Management Program has a unique leadership role

as the coordinator of health care provider training programs, and also acts as the transfer

payment agency for the MOHLTC funding of these programs for the 13 Self-Management

programs. Work will be underway to determine next steps for this component of the program.

This year the program is offering a new program, Powerful Tools for Caregivers, specifically

designed for caregivers. It is being offered as a pilot project using existing program funds from

the LHIN budget and will consist of six Powerful Tools for Caregivers workshops throughout the

region this fiscal year. Two staff and two volunteers travelled to the United States at the end

of March to receive the training and the Central East LHIN Self-Management program will be

the first organization to offer this program in Ontario. Workshops are six weeks in length for

1. 5 hours each week, and are focused on how to help support caregivers’ health with a focus

on providing self-care tools to reduce personal stress, enhance communication skills with health

care providers and family members, and make difficult caregiving decisions.


Strategic Goals


☐ Develop Our People ☒




☒ Provide Healthy Safe

Workplaces

☐


☒ Deliver High Value, Outcome-

based Care

☐ Support Flexible Work

Environments

☐


☒ Be an Innovative Learning Organization


☒ Enable Service Excellence ☒


Finance Report

The Central East CCAC achieved a balanced position for the base portion of the 2015/16 budget.

The balanced position was not easily achieved. Growth in patient numbers and service volumes

in Q1/Q2 2015/16 required the implementation of mitigation strategies including a staff hiring

freeze, waitlists for adult therapy patients and updates to our service planning guidelines.

As illustrated in the table below we had considerable growth in our waitlists over the last fiscal

year as a result of our financial pressures. While waitlisted patients receive case management

support and referrals to other community supports where applicable, they typically have high

home care service needs which remain unmet creating risks for these patients and increased

caregiver burden. As we have communicated to you previously, we are most concerned with

the risk inherent in those patients on the enhanced personal support waitlist who currently have

CCAC services, but have been reassessed and need more service hours than they are currently

getting.

April 1/15 March 31/16 Estimate to

Eliminate Waitlist

Adult Therapy Services 0 247 $0.3M

Enhanced Personal Support 472 1,053 $4.1M

Personal Support 1,438 2,304 $18.1M

The Central East CCAC is continuing to see growth in patient numbers and demand for services

beyond our resources and we will continue with the mitigation strategies implemented in 2015

through the 2016/17 fiscal year to reach a balanced position again this year.


Strategic Goals


☒ Develop Our People ☐





Workplaces

☐



based Care


Environments

☐






Outstanding Place to Work

Build on the strengths, expertise and leadership capacity of our people and continuous quality improvement in a healthy, safe and energized workplace.

LEADS to Success Performance Development Program

In an effort to maximize the success of the LEADS to Success Performance Development

Program and improve our impact and the completion rate, Human Resources and Organizational

Development staff are now offering one-on-one support with our managers to help them be

successful in completing their performance assessments. The support has helped managers

identify and work through issues they have with the program and/or electronic system and to

provide support in their completion rate. This support has resulted in a 24% improvement in

the number of development plan assessments performed and a 13% increase in the number of

full performance assessments completed from January 2016 to the end of April 2016. This

quality improvement initiative has had a significant impact on not just the number of

assessments completed, but on the quality of the assessments and understanding the value of

the assessments.


Strategic Goals

Optimize Health Outcomes ☐ Balance Our Budget






Workplaces

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based Care


Environments

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Central East CCAC 2015 Awards for Excellence Program

This year, the Central East CCAC Awards for Excellence Program received a total of 28

nominations in the categories of Leadership, Lesley Hanley Compassionate Care, Staff Team,

Individual, Citizenship and Systems Partnership. Congratulations to all of our nominees!

It gives us great pleasure to announce the Award recipients:

The Lesley Hanley Compassionate Care Award goes to Michael Devanathan, Care

Coordinator, Scarborough Branch. Michael always demonstrates a professional,

understanding and caring attitude with his patients, their families and his colleagues and has

made a remarkable difference in the lives of his patients and their families. He is compassionate,

patient, hard-working and demonstrates every day that his patients matter. He is respectful

and positive in his demeanor and is consistently ready to support his colleagues when his help

is requested.


The Leadership Award goes to Mandy Lee, Quality Improvement Facilitator, Health

Links, Whitby Branch. Mandy has demonstrated exceptional leadership growth since taking

on the facilitator role. She is continuously reaching out to the community, building capacity

with partners and ensuring that interactions are undertaken with care and in a collaborative

spirit. Mandy sparks innovation with the partners by encouraging them to develop creative

solutions to address complex health care issues centred around the patient and caregiver. She

leads multiple meetings per week with partners to facilitate collaboration between them and is

effectively building relationships. As a result, partnerships have been developed and partners

are now working better together to coordinate care for complex patients; partners are now

coming to meetings, sharing their data and attending Coordinated Care Conferences. Mandy

was also instrumental in the development of the Central East Health Links Coordinated Care

Planning Toolkit which is recognized provincially and has been shared with the other 81 Health

Links across Ontario. Mandy will be presenting at the OACCAC Conference 2016 on the Toolkit.

The Citizenship Award goes to Khosrow Yazdanhi, Physiotherapist, Peterborough

Branch. Khosrow has supported the immigration of Syrian families to Canada by providing an

apartment in his home for the use of a Syrian Refugee family of 6 with no monetary

compensation. As they do not speak any English, Khosrow has been using a phone app to assist

with communication. He has assisted the family in obtaining clothing, furniture, household

items, taken them to cultural and community events to show them what a great place Canada

is to live and introduced the family to tobogganing, swimming, and skating. Khosrow has put

the values of the CECCAC to work in his own life by taking the responsibility for helping to house

this family and provide them with more than just a place to live.

The Individual Award goes to Debbie Orr, Operations Manager, Peterborough Branch.

Debbie embodies the values of the CECCAC in her daily interactions with her staff, the

employees across the Peterborough branch, within the management team and in any interaction

with patients of our catchment area. Debbie has demonstrated a commitment to caring and

support of her team and shows respect and compassion to all employees.

The Staff Team Award goes to the Community Palliative Care Nurse Practitioner Team,

CECCAC - Dean Walters, Tarik Towfeq, Valerie Joseph, Franzis Henke, Angela Resetar,

Sondra LeBlanc, Kianda Mauch, Kathy Younker, Aynsley Young, Isobel Manzer, Alda

Steprans, and Kaitlin Loudon. The Community Palliative Care Nurse Practitioner Team

provides exceptional medical care, support and compassion while honouring the wishes of

patients and their families, enabling patients to die in their place of choice. They not only

provide best practice through their own advanced knowledge skill and judgement but mentor

community nurses and partners to increase capacity and support for best care and best practices

of all those who care for the patient. This team not only provides support to the patient, family

and other community partners – but because of the type of work they do in dealing with death

and dying on a daily basis, they have developed their own support network amongst themselves,

meeting on a frequent basis to support, care for, debrief and provide recommendations to each

other as they care and nurture each other. The team works together to share their own


research, best practices, present at conferences and volunteer in our communities. They truly

demonstrate the values of the CECCAC with each other within their team.

The Systems Partnership Award goes to the Combined Palliative Care Service Delivery

Model Project Team – Michelle Nurse, Wanda Parrott, Jill Moore, Charmaine Hermoso,

Liza Maw, Jacklyn Kerr, Andra Duff-Woskosky, Jill Ritchie, Marci Pawlowski, Kianda

Mauch, Franzis Henke, Gail Scala, Pamela Desrochers, Diana Bastin, Lisa Burden,

Sandra Armstrong, Jan Adams, Cindy Massey Straus, Cindy Crossley, Lisa Stephens,

Dianne Low, Amanda Vasquez, Kimberly Mauro, Lynn Park (SEHC), Caroline Sleep

(SEHC), Sue Beattie (VHA), Barbara Cawley (VHA), Courtney Bean, (VHA), Joy Klopp

(VHA), Dianne Olsen (ParaMed), Tracey Stevenson (ParaMed). A project team of

CECCAC employees and our Service Providers partners developed a Combined Palliative Care

Delivery model to improve the patient care, and patient and family experience. The model

consists of locally-based specialized and designated care teams supporting our patients to

access the services they need in living the end of their lives comfortably at home with

coordinated access to high quality, specialized palliative care services 24/7 across the Central

East LHIN geographic boundary. The goal of the model is to provide nursing and personal

support worker services from one agency within a geographic area to facilitate better

communication and coordination across the interdisciplinary team, optimize nursing and PSWs

resources, improve management of delegated acts from nursing to PSW and enhance the skills

and knowledge of the staff engaged in palliative care.


Strategic Goals


☐ Develop Our People ☒





Workplaces

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based Care


Environments

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OACCAC Conference 2016

The Achieving Excellence Together 2016 OACCAC Conference will be held June 5-7, 2016 at the

Westin Harbour Castle Hotel in Toronto, Ontario. This year, we have a total of 75 employees

and board members attending the conference. This includes 5 board members, 23 management

and 47 front line staff members

Central East CCAC has submitted two nominations to the OACCAC Awards for Excellence

Program:

Staff Team Award Nomination

The Central East CCAC Mental Health and Addiction Nurses worked together as a team to

support the Durham District School Board address the complex issues impacting poverty,


readiness for school and student achievement, and enhance the provision of resources and

integrated services to schools within the Board through the “Make a Difference Project”. This

project is helping to enhance the provision of resources and integrated services to schools

within the board by promoting the mental health and well-being of children, helping them learn

strategies they can use in their everyday lives to effectively deal with stress, manage their

emotions, enhance their self-esteem, improve their relationships, and increase their emotional

awareness. The Mental Health and Addiction Nurses supporting the program demonstrated

leadership and inspiration through the design and development of the evidence based

curriculum while working in partnership with the Durham District School Board (DDSB). Their

passion in their work and connections with the students was shown through the surveys and

students anecdotal experiences.

Systems Partnership Award Nomination

A project team of Central East CCAC employees and our Service Providers partners developed

a Combined Palliative Care Delivery model to improve the patient care, and patient and family

experience for our palliative patients. The model consists of locally-based, specialized and

designated care teams supporting our patients to access the services they need in living the

end of their lives comfortably at home with coordinated access to high quality, specialized

palliative care services 24/7 across the Central East LHIN geographic boundary. The goal of the

model is to provide nursing and personal support worker (PSW) services from one agency within

a geographic area to facilitate better communication and coordination across the

interdisciplinary team, optimize nursing and PSW resources, improve management of delegated

acts from nursing to PSWs and enhance the skills and knowledge of the staff engaged in

palliative care.

Successful nominees will be announced during the OACCAC Conference Awards Banquet on

June 6th, 2016.

In addition our Health Links abstract was accepted for presentation at the OACCAC Conference

this year - Supporting the Spread of Health Links and Coordinated Care Planning in the Central

East LHIN – by Mandy Lee, Quality Improvement Facilitator, Health Links and Andrea Smith,

Manager, Health Links.

The Central East Health Links developed an Engagement and Education Strategy to facilitate

the collaboration between Health Link partners and other care providers. The strategy was

developed as the result of a gap analysis performed by the Project Management Office to

identify challenges experienced by the Health Link partners. The strategy involved developing

a Coordinated Care Planning Framework to integrate coordinated care plans into existing

programs. This framework is used by Health Links partners to incorporate the coordinated care

plan and a coordinated care conference into their existing processes. The strategy includes the

Central East Health Links Toolkit to support coordinated care planning and engage care

providers through education sessions, supports integration of the Coordinated Care Plan, and

offers community sharing events to facilitate knowledge exchange and collaboration.



Strategic Goals







Workplaces

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based Care


Environments

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Employee Engagement Survey

The results of the CCAC Employee Engagement Survey show an engagement rate of 67.9%.

The HROD PET has been reviewing the results of the survey in great depth – looking at

responses collected from over 35 reports. Comments from the survey told us that change –

the number of changes, the rate of change, how change is managed and supported, employee

input into changes and how change is communicated, was the number one concern. Higher

percent positive scores were noted in questions around the employee’s relationship with their

colleagues, patients and teams and lower percent positive scores were noted in questions

around the employee’s relationship with the organization.

Based on this review, members of the PET are going through brain storming sessions to

determine where we should be focusing our attention. A vision of what needs to happen to

improve our engagement has been discussed, along with what is our current reality, what has

to change to align with our vision and if it is possible, how do we make it happen? The vision

identified includes items such as trust between managers and front line staff; employees feel

their voice has been heard; all employees are held accountable for their actions; communication

is specific and targeted; the value of work done is acknowledged and for everyone to walk the

talk. The HROD PET is now looking at a number of strategic actions that will help us improve

our engagement. These strategies revolve around change, communication and the

implementation of the Canadian Psychological Health and Safety Standards.


Strategic Goals







Workplaces

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based Care


Environments

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Workforce Management (Synerion)

Currently, the Central East CCAC utilizes Outlook calendars, Excel spreadsheets and Quadrant

Workforce to track employee data and schedules. The current processes are inconsistent across

our geographical locations and they are highly manual with minimal integration. This results

in frequent duplication of data entries, lack of visibility into team schedules and processes that

are not streamlined or efficient. As a result of this need, a procurement process was undertaken

to seek a more effective electronic solution; the Synerion Workforce Management Solution was

selected.

The overall goal is a transparent and accurate platform for managers and frontline employees

to view and monitor individual team attendance, staff coverage, staff whereabouts (for example

planned & unplanned absences), home visits, etc. The new scheduling/workforce management

software is an integrated system that will provide more accurate information and support more

streamlined processes, resulting in numerous benefits including better forecasting of staffing

needs, more accurate intraday coverage, as well as enhanced communication and sharing of

information to support staffing decisions.

Testing and training for the new solution started on April 28, 2016 in parallel with existing

systems and processes. Full implementation is planned for the summer of 2016.

Accessibility Status –AODA

The Central East CCAC continues to develop processes and policies to ensure that the

organization provides an accessible environment. In December of 2015, the organization

updated the multi-year accessibly plan to ensure that the Accessibility for Ontarians with

Disability (AODA) Employment Standards are integrated into our recruitment and

accommodation processes. In January of 2016, a quality improvement team was struck with

an initial goal to create a policy and procedure to support the AODA requirement of providing

accessible formats and communication supports upon request. The secondary goal is to create

a reference guide of available resources for the Central East CCAC.



Strategic Goals







Workplaces

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based Care


Environments

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Disability Management

In an effort to improve our disability management, we are re-focusing our Workplace Health

and Safety programs to be more abilities, driven rather than focusing on disabilities or

restrictions. In addition our medical forms have been updated to be more comprehensive by

allowing us to focus on employee’s abilities. To support this process we have introduced a

Registered Health Care Medical Form and updated physical demand forms, which mirror the

physical demands analysis of our current ONA and CUPE job descriptions. We have also

developed a cognitive abilities form to help support employees with psychological restrictions

since this is an area we see increased needs based on the demographics of our claims. These

updated forms will help facilitate more supported Return to work (RTW) and work

accommodations (W.A).

For 2015/16 our team managed 174 new claims.

Our Workplace Health and Safety (WHS) staff strives to support employees experiencing

challenges at work due to either temporary or chronic illnesses/injuries. Work accommodations

can be a proactive approach by supporting an employee who may not have been away from

work. This year WHS has initiated many “stay at work” strategies through our accommodation

program to support those employees to be successful at work. Recently, the individual

employee work accommodation plan forms have been amended to ensure that any long term

plans are being reviewed. It has been identified that due to organizational changes and/or the


employee’s medical condition changes that a formal review process helps ensure that the work

accommodation continues to be supportive over time.

Safety

Last year we continued to provide health and safety education to promote a safe work

environment for our staff. We are pleased to report that we had a total of 49 incidents reported

which is a decrease from the previous 2 years.

2015 Incidents by Type

In terms of Workplace Safety and Insurance Board (WSIB) accident history, the Central East

CCAC has performed better than similar employers in each of the past 4 years, and this has

been reflected in our New Experimental Experience Rating (NEER). The NEER is an experience

rating program that looks at the organization total of WSIB benefits paid, the projected future

costs of claims over their expected lifetime, and an administrative cost. A portion of the

difference between the expected costs and NEER costs are either refunded or charged back to

Slip/Trip/Fall35%

Motor vehicle accident

14%Overexertion10%

Repetition8%

Workplace violence8%

Harmful substance/environm

ent6%

Communicable disease

4%

Insect bite4%

Abrasion/laceration2%

Other2%

Animal bite2%

Not applicable2%

Property damage2%

Struck/caught0%

Burn0%

Unknown0%

Exposure to body fluids

0%


the firm. Over the past 5 years, we have received close to $500,000 in WSIB rebates due to

our good accident history record.

This year we successfully completed 22 physical demands analyses (PDA) on our CUPE and

ONA jobs. A physical demands analysis breaks down each job task that the worker performs

and measures the physical demands of each of those tasks.

Having the PDA allows us to better accommodate and return employees to work as we can

compare the physical demands of the job tasks to the functional abilities of the worker. This

will help us determine if and how we can accommodate employees in their original position or

explore other options available. It is also an essential piece of information to facilitate early

and safe return to work for our employees.


Strategic Goals







Workplaces

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based Care


Environments

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of 3

Performance Quality and Effectiveness Committee

Meeting

Wednesday, May 4, 2016

Central East CCAC – Whitby Branch

6:30 p.m. – 8:30 p.m.

MINUTES

Present: Nicola Crow (Chair), Carmen Rapati, Derrick McLennon, Len Lifchus, Kathryn

Ramsay, Michelle Nurse, Dave Stringer, Lisa Burden, Kathy Romas Jaeger

Regrets: None

Recorder: Christine Lomas

1. Meeting Agenda and Approval

1.1. Call to Order

Meeting was called to order at 6:31 p.m.

1.2. Declaration of Quorum

Quorum was met

1.3. Approval of Agenda

MOTION: To approve the proposed modified agenda, with the addition of Item 3.2.

Year End Review, and defer Item 2.3. until the June meeting.


SECOND: Derrick McLennon CARRIED

1.4. Declaration of Conflicts

No conflicts were declared.

1.5. Approval of Minutes

MOTION: To approve the minutes of March 2, 2016 and April 6, 2016


SECOND: Derrick McLennon CARRIED

2. Business Arising

2.1. Q4 2015/16 Organization Performance Report

2.1.1. Report Discussion – Michelle Nurse

A summary was given of the Q4 2015/16 Organization Performance Report with the

following points noted:

of 3

The Patient and Caregiver Overall Experience is down slightly at 91.6% and work is

being done to understand the contributing factors. It was noted that changes to the

safety questions within the survey and the introduction of the patient advisory

committee may help to improve the scores.

Outstanding Place to Work (Employee Engagement, Absenteeism, and Performance

Review Rate) are also below the performance targets, and potential contributing

factors include the labour disruption and the pending CCAC/LHIN transition.

Falls Among Long-Stay Home Care Patients is trending up, and this is in part

attributable to the increased complexity of our patients. As well, with the

introduction of the falls prevention initiative the reporting of falls has increased.

Appendix C: Central East CCAC LHIN Benchmark Data Report has been replaced; the

new report compares all 14 CCAC’s.

Patients by Client Care Population per Quarter data shows that the adult complex

population is growing a few percentage points each year. Although the percentage

increase is low, the financial impact is high. The adult chronic population numbers

are also increasing. The Community Independence population are decreasing as we

discharge patients to the assisted living programs. The adult short stay population

are also decreasing which is related to our rehabilitation waitlist criteria that were

implemented.

A new report has been added to the Organization Performance Report, entitled the

Service Provider Scorecard Quarterly Summary by Service. This report provides a

snap shot of some of the performance metrics that are used to evaluate service

provider performance.

2.1.2. Identification of Follow-Up Discussion Metric

A decision was made to focus the follow-up discussion on the Outstanding Place to

Work metrics. As well, the committee requested that the 5-Day Wait Time metrics

be added to the agenda for the October Meeting. It was also noted that the target for

the 5-Day Wait Time metrics should be changed from 86.6% to 95% to match the

Multi-Sector Accountability Agreement expectation.

2.1.3. Identification of Improvement Initiative

The Committee decided to combine the follow-up discussion and improvement

initiative focus on the Outstanding Place to Work metrics, which include Employee

Engagement, Absenteeism and Performance Review Rate. Garth Johns will be invited

to the June PQE meeting to present this topic.

2.2. Cultural Competence and Diversity Committee Update – Kathy Romas

Jaeger

An update was provided on the newly formed Cultural Competency and Diversity

Committee. Sixteen employees were selected to participate on the committee. All

members were asked to provide a brief introduction of their background and

interest in the committee. The membership includes staff members from

Scarborough, Whitby, Peterborough, Port Hope and Lindsay offices. More than half

the membership is frontline staff.

During the first meeting, the members established a Terms of Reference, identified

a plan for promoting the committee, and discussed staff training opportunities.

Members of the committee will attend a pilot training session on cultural

competency in June. This training will be offered to all staff starting this fall.

of 3

An update will be provided to the PQE Committee with the next review of the

Cultural Competence and Diversity Plan in 2017.

There was a question regarding whether the committee had thought of including

representation from the patient point of view; this suggestion will be brought back

to the committee for consideration. It was also noted that there is a difference

between cultural diversity sensitivity and expertise; staff committed to being aware

of this and the need to bring in additional expertise if required.

2.3. Review of PQE Committee Evaluation Results – Nicola Crow

Deferred until the June meeting.

3. New Business

3.1. Accreditation Update – Kathy Romas Jaeger

An update was provided on Accreditation. Although there were no mandatory

recommendations put forth from the last survey, there were suggestions provided by

the surveyors that are being implemented.

3.2. Year End Review – Nicola Crow

It was suggested that it would be valuable to have a document that captures all of

initiatives that were presented during the PQE Committee meetings this past year. A

short summary from the presentation will be included as well as a short paragraph

explaining the present status of the initiatives.

ACTION: Christine Lomas and Kathy Romas Jaeger will work on pulling information

from each meeting for the 2015/16 year and provide a document to Executive.

4. Standing Items

4.1 Messages to the Board—Nicola Crow

Committee members identified that the Q4 Organizational Performance Report,

cultural diversity committee start up and the employee engagement were topics that

should be noted for the Board.

4.2. Risk Management Update—Kathryn Ramsay

Michelle Nurse provided an update.

Adjournment – Meeting adjourned at 7:34 p.m.

__________________________________ _____________________________

Nicola Crow (Chair) Date

central east ccac board agenda -...

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