Waterloo Wellington CCAC Streamlining Services For High and Lower Need Patients Building Community Capacity - A Collaborative Planning Initiative for CCAC and CSS

Context WWCCAC strategic plan work underway is positioning the organization for the future. WWCCAC is defining its target population and will focus services on moderate to high complex patients. The context of this initiative considers the findings in the Sinha Report. Excerpt from Dr. Sinha’s Report – Living Longer, Living Well  KEY RECOMMENDATION : Enhance the Provision of Home and Community Care Services  “The Ministry of Health and Long Term Care should support the LHIN’s their CCAC’s and CSS agencies to formalize a collaborative Standardized Care Model that can allow acuity based wait-lists and Care Coordination assignments between CCAC’s and select CSS Agencies. This will allow both sectors to provide publicly funded personal support services in each LHIN. This will allow both sector organizations to play to their strengths and better address client needs.” 1

Context Cont’d  The volume of client referrals to CCACs from the hospitals has increased (due to initiatives to reduce hospital length of stay and ALC days and improve patient flow)  The increased volume of higher acuity clients on CCAC caseloads adds tremendous pressure on CCAC budgets and lower needs clients may end up waiting for service  The Seniors Strategy for Ontario recommends that LHINs, CCACs and CSS agencies formalize a Standardized Collaborative Care Model and collectively build the capacity to enable CSS agencies to provide PSW services to lower needs clients  WW CCAC’s strategic planning work aligns nicely with this opportunity to work collaboratively with the LHIN, CCAC and CSS sector to consider how to:  Best serve the lower acuity home care clients  Collectively build capacity across the community sector  Deliver the best value for money  Effectively facilitate patient flow through the healthcare system 2

Context Cont’d  The WW LHIN envisions greater system capacity, improved patient satisfaction and outcomes and more effective transitions with greater patient support through the continuum of care through the efforts of this initiative  KEY DRIVERS INCLUDE A DESIRE TO: Create “Early -Single Entry Point -Coordinated Access” to care Shift CCAC resources to higher needs– higher acuity clients Find better solutions through a more robust CSS Network for lower needs – lower acuity clients Ensure services are “targeted” Focus on transitions to better suited partner providers within the CSS Network Engage all stakeholders through the process Ensure the process is transparent and open 3

Project Overview – Mission and Success  Work in partnership with the WWLHIN, CCAC and CSS sector to develop a plan that will enable CSS agencies to provide personal support worker services to certain categories of home care clients 4  A collaboratively developed plan that establishes the strategy, processes, structures, roles, capacity and operations required to shift the care of some categories of home care clients from the CCAC to CSS agencies  A well-defined implementation plan that identifies the key tasks, roles, responsibilities and considerations for all partners to ensure clients receive the support they require from the CCAC and CSS agencies  The collaborative development of key governance and accountability terms and agreements to ensure that all parties clearly understand their relative authorities, accountabilities and responsibilities Project Mission Project Success

Project Overview – Scope 5 In Scope Out of Scope  An Environmental Scan of Leading Practices for this client population  Stakeholder Engagement  A Business Plan identifying benefits, risks and recommended operational processes, policies, roles and responsibilities  Implementation Plan with Accountability Tools (i.e. Draft Memorandum of Understanding)  Implementation of Recommendations  Award of PSW Business to CSS Agencies  Transition of CCAC Clients to CSS Agencies

Project Advisory Committee  The advisory committee has met three times since the project inception - March 7 th, April 3 rd and April 30 th. It is expected the committee will met another 4 times before the completion of this project  Communiques of each meeting will be available on our website and sent directly to key stakeholder networks.  Comments, feedback and questions are welcomed by Gloria Cardoso, WWCCAC Senior Director – Planning, Communications & Community Engagement, at or (519) ext.  Cathy Harrington, co-lead of the CSS Network and Executive Director of the Community Care Concepts is also willing to take questions and comments. Cathy can be reached at or (519) 6 Gloria CardosoWaterloo Wellington CCAC – EXECUTIVE LEAD Cathy HarringtonCommunity Care Concepts – Co Lead Michelle MartinVictorian Order of Nurses Joanne Young EvansGuelph Independent Living Dale HowattCommunity Support Connections Lisa Bitonti-BengertWaterloo Wellington LHIN Barry MonaghanWaterloo Wellington CCAC Leanne MurrayWaterloo Wellington CCAC Martina RoszaWaterloo Wellington CCAC Dana KhanWaterloo Wellington CCAC

Project Overview – Guiding Principles The advisory committee developed the following Guiding Principles for the Initiative  To Be Patient/Client-Centred  To Be Data Driven And Evidenced-Based  To Position The Community Sector For Greater Capacity To Prepare For The Future  To Better Utilize Resources By Leveraging Technology  To Ensure Policy Alignment  To Be Fiscally Responsible and Ensure Value for Dollars 7

Project Plan 8 We are here May April March Advisory Mtg. June July Project Management, Monitoring, and Control Project Plan Data Collection and Analysis Project Launch Environmental Scan of Leading Practices Business Plan Development Stakeholder Engagement Benefit and Risk AnalysisImplementation Planning Milestone Contracted Service Provider Advisory Committee First Advisory Mtg. Advisory Mtg. CSS network engagement Advisory Mtg. Contracted Service Provider Advisory Committee We are here.

Early Project Considerations  Appropriate stakeholder representation in the project structure  Clear roles and responsibilities for project members  Ensure the planning process is open and transparent 9 Project Structure Considerations  Establish the list of all key stakeholders early in the project  Provide multiple channels and opportunities to provide input to the plan  Ongoing communications and updates – all stakeholders have easy access to all relevant planning information  Identify barriers and risks that may limit the degree of stakeholder support for the project Broad Stakeholder Engagement Considerations

Current Project Undertakings Data Collection and Analysis  Current utilization, wait list, number of health human resources (HHR)  Services offered - (service type offered)  Current active patient volume (separated by service type) Environmental and Jurisdictional Scan of Leading Practices  Research and present innovative models of community sector partnership for target populations e.g. lower need persons  Identify key model considerations and dependencies (infrastructure, capacity etc.)  Assess state of local sector readiness based on degree of change in various models  Identify preferred model options 10

Key Stakeholder Engagement  CSS Network  CCAC Contracted Service Providers Advisory Committee  SGS, Retirement homes  Planned Phone Interviews:  WWLHIN  MOHLTC - Catherine Brown  OCSA - President and CEO  OACCAC  Key LHIN Senior Leaders who have successfully help build CSS Capacity  MH, Champlain, Central East, Toronto Central  Key CCAC Senior Leaders who have work underway to transition lower need population to CSS  MH CCAC, Champlain  CSS Thought Leaders across the province  Survey:  CCAC’s 11

Stakeholder Engagement Findings Highlights April 9 th CSS Network Meeting  It is simplistic to think in terms of ‘low’ and ‘high’ needs clients  Can’t base evaluation solely on RAI scores (blend of art and science)  Broad range of services and providers  Need to determine where there is capacity  Don’t forget about (specialty services, ABI, rec centres and wellness, dementia)  How will care coordination be differentiated for CCAC and CSS? April 16 th Contracted Service Provider Advisory Committee  What will be the impact on SP PSW market share?  CCAC transitioning to higher need population is consistent with other CCAC’s provincially  PSW’s may choose to go to a CSS agency if the population care is lighter  What are the HHR considerations knowing PSW’s are in demand. What are the union implications if staff are moving from one organization to another? 12

Immediate Next Steps 13 Next Steps Completion Target 1 Final draft environmental and jurisdictional scanMid May 2 Finalize data collection and analysisMid May 3 Stakeholder InterviewsOngoing 4 Draft Benefit and Risk Analysis Week of May 12 th

Questions 14 Do you have any questions or comments about the project? Do you have suggestions for us as we consider this planning moving forward?