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BRIEFING NOTE

Mission: To lead a high-quality, integrated health system for our residents


Vision: Better Health Better Futures
Core Value: We value acting in the best interest of our residents health and wellbeing
MEETING DATE:

May 28, 2015

ACTION:

Decision

TOPIC:

Item 7.0 - Consent Agenda

PURPOSE:
To provide a summary list of recommendations from the reports on the consent agenda for the Board meeting on
May 28, 2015.
BACKGROUND INFORMATION:
SUMMARY OF ITEMS ON THE CONSENT AGENDA:
a) Minutes:
THAT the minutes of the previous meetings held on March 26, 2015 be approved as circulated.
b) Chair Report:
THAT the Chair Report for May 2015 be received for information.
c) CEO Report:
THAT the CEO Report for May 2015 be received for information.
d) Finance & Audit Committee Report:
THAT the Waterloo Wellington Local Health Integration Network Board of Directors receive the Finance
& Audit Committee Report from March 26, 2015 as information.
e)

Governance Committee Report:


THAT the Waterloo Wellington Local Health Integration Network Board of Directors receive the
Governance Committee Report from March 26, 2015 as information.

f)

2014/15 Audit Results:


THAT the Board of Directors approve the 2014/15 Audit Results as recommended by the Finance and
Audit Committee.

NEXT STEPS:
N/A
RECOMMENDATION:
THAT the items of the consent agenda for May 28, 2015 be accepted.

Consent Agenda
Item 7.0 A

WWLHIN Board of Directors


March 26, 2015

Page 1

Waterloo Wellington Local Health Integration Network


Board of Directors Meeting
MINUTES
Thursday, March 26, 2015
The following are the minutes of the Board Meeting held at 12:00 p.m. on Thursday, March 26,
2015 at the Waterloo Wellington LHIN office, 50 Sportsworld Crossing Road, Suite 220, Kitchener,
ON.
Members
Present:

J. Fisk (Chair), M Basi, B. Dinwoody, M. OBrien, J. Nesbitt & B. Larkin

Regrets:

D. Small (Vice-Chair)

Staff Present:

B. Lauckner ,T. Lemon, S.Rous, S. Oakley & Z. Danis

Recording
Secretary:

D. Ruprecht

1.0

Call to Order & Recognition of Quorum


J. Fisk called the meeting to order at 12:02 p.m. and welcomed members to the meeting.

2.0

Approval of the Agenda


Motion No. 65-14-15 Moved by M. Basi, seconded by B. Dinwoody and unanimously
approved with the amendment of item 15.0 Hospital Service Accountability Agreements (HSAA) presented before item 9.0 Chairs report, to accommodate presenters availability:
THAT the agenda be approved as circulated.

3.0

Declaration of Conflict of Interest


All Board members stated that there were no declarations of conflict of interest made in
relation to the matters to be dealt with on the agenda with the exception of M. OBrien in
relation to item 11.0 Secretary Reappointment where he will refrain from the discussion and
vote due to the conflict of interest in his current role as Board Secretary.

4.0

Closed Session
Motion No. 66-14/15 Moved by M. OBrien, seconded by J. Nesbitt and unanimously
approved:
THAT the meeting adjourn and move into a closed session for the
purpose of a discussion about matters of such a nature that the
desirability of avoiding public disclosure of them outweighs the
desirability of adhering to the principle that Board meetings be open
to the public under section 9(5) (a) of the Local Health System
Integration Act, 2006.

WWLHIN Board of Directors


March 26, 2015

Page 2

Note: The open session adjourned at 12:02 p.m. to move into closed session
Note: The closed session adjourned at 1:55 p.m.

WELCOME
J. Fisk welcomed Board members and guests to the meeting at 2:02 p.m.
5.0

Reconvening the Open Session


Motion No. 67-14/15 Moved by B. Dinwoody, seconded by M. Basi and unanimously
approved:
THAT the open session reconvene.

Note: The open meeting reconvened at 2:02 p.m.


6.0

Report of the Closed Session


J. Fisk reported that the Board met in a closed session from 12:02 p.m. to 1:55 p.m. for the
purpose of discussions about matters of such a nature that the desirability of avoiding public
disclosure of them outweighs the desirability of adhering to the principle that Board
meetings be open to the public under section 9(5) (a) of the Local Health System Integration
Act, 2006.
Motion No. 68 -14/15 Moved by M. Basi, seconded by B. Larkin and unanimously
approved:
THAT the Board receive the Chairs report of the closed session for
information.

7.0

Consent Agenda
The following item was on the Consent Agenda for March 26, 2015.
a)

Minutes:
THAT the minutes of the previous meetings held on January 29, 2015 be approved
as circulated.

b)

Chair Report:
THAT the Chair Report for March 2015 be received for information.

c)

CEO Report:
THAT the CEO Report for March 2015 be received for information.

d)

Finance & Audit Committee Report:

WWLHIN Board of Directors


March 26, 2015

Page 3

THAT the Waterloo Wellington Local Health Integration Network Board of Directors
receive the Finance & Audit Committee Report from January 29, 2015 as
information.
e)

Governance Committee Report:


THAT the Waterloo Wellington Local Health Integration Network Board of Directors
receive the Governance Committee Report from January 29, 2015 as information.

f)

BPSAA Attestation for Q4 2014-15:


THAT the Board accept the CEO Certificate of Compliance for Q4 (2014/2015) and
that the Board Chair sign (1) the Declaration of Compliance and (2) the Attestation of
Compliance to the Broader Public Sector Accountability Act (BPSAA), pending any
revisions as of March 31, 2015, and submit both to the Minister of Health & LongTerm Care.

g)

CMH Working Funds Approval for Q3 2014/15:


THAT the Waterloo Wellington Local Health Integration Network Board of Directors
direct the CEO and Board Chair to sign the Cambridge Memorial Hospital Q3
2014/15 Hospital Working Funds Initiative Report for submission to the Ministry of
Health and Long Term Care.

h)

2015/16 Operating Budget:


THAT the Waterloo Wellington Local Health Integration Network Board of Directors
approve the WWLHIN 2015/16 Operating Budget pending confirmation of funding
from the Ministry of Health and Long-Term Care.

Motion No. 69 -14/15 Moved by J. Nesbitt, seconded by M. OBrien and unanimously


approved:
THAT the items on the consent agenda for March 26, 2015 be
accepted and approved.
STRATEGIC AGENDA

9.0

Hospital Service Accountability Agreements (H-SAA)


M. Samac provided the Board with an update on establishing the Service Accountability
Agreements (SAAs) for hospitals in 2015/16 and extending the terms and accountabilities
of the current Service Accountability Agreements to March 31, 2016.
Motion No. 70-14/15 Moved by J. Nesbitt, seconded by M. Basi and unanimously
approved:

WWLHIN Board of Directors


March 26, 2015

Page 4

THAT the Waterloo Wellington Local Health Integration Network


(WWLHIN) Board of Directors direct the CEO and Board Chair of
the WWLHIN to execute the proposed Hospital Service
Accountability Agreement (H-SAA) Amending Agreements to be
made as of April 1, 2015, and amending the 2008/15 H-SAA by
extending its term to March 31, 2016 and by replacing the current
schedules with 2015/16 schedules.
and
THAT the Waterloo Wellington Local Health Integration Network
Board of Directors direct the CEO and Board Chair of the WWLHIN
to execute the proposed Private Hospital Service Accountability
Agreement (PH-SAA) Amending Agreement to be made as of April
1, 2015, and amending the 2008/15 PH-SAA by extending its term
to March 31, 2016 and by replacing the current schedules with
2015/16 schedules.
11.0 Re-Appointment of Board Secretary
J. Fisk provided the Board with background information about the Board Secretary position
and make a recommendation to re-appoint a Secretary for the Waterloo Wellington Local
Health Integration Network (WWLHIN) Board of Directors.
Motion No. 71-14/15 Moved by J. Nesbitt, seconded by B. Dinwoody and unanimously
approved:
THAT Murray OBrien be re-appointed as the Board Secretary for the
WWLHIN Board of Directors for fiscal 2015/16.
12.0 Health System Annual Plan Q4 Progress & Risk Review
E. Fung provided the Board with an update on progress in and risks to accomplishing the
Waterloo Wellington Annual Plan for health system improvement
13.0 Waterloo-Wellington Current State of Long Term Care
E. Fung and M. Innocente presented to the Board the current state of services within the
Waterloo-Wellington area for Long-Term Care and to identify opportunities for improved
care and service within the WWLHIN system which can be used to prioritize the need for
new or expanded services as funding opportunities are identified.
14.0 Caressant Care Bed Transfer
E. Fung provided the Board with an update and recommended a decision regarding the
proposed transfer of 9 long term care bed licenses from Caressant Care Harriston and 7
long term care bed licenses from Caressant Care Fergus to Caressant Care Cambridge
Country Manor.
Motion No. 72-14/15 Moved by B. Larkin, seconded by M. Basi and unanimously
approved:

WWLHIN Board of Directors


March 26, 2015

Page 5

THAT the WWLHIN Board of Directors support the proposed


transfer of 9 long term care bed licenses from Caressant Care
Harriston and 7 long term care bed licenses from Caressant Care
Fergus to Caressant Care Cambridge Country Manor.
15.0 Community Investments to Support the Realization of the Annual Business Plan
E. Fung informed the Board of Directors on the Waterloo Wellington LHIN on Annual
Business Plan (ABP) progress and recommend base funding investments to align with
system priorities that support the realization of ABP initiatives and Ministry of Health and
Long Term Care-LHIN Accountability Agreement obligations.
Motion No. 73-14/15 Moved by B. Dinwoody, seconded by M. Basi and unanimously
approved:
THAT the LHIN Board approve the following base funding
recommendations:
1. $1,072,300 to the Waterloo Wellington Community Care
Access Centre to support the transition of personal support
services to lower acuity clients who are better served in the
Community
2. $621,681 to St. Josephs Health Care Guelph to enhance the
Behavioural Supports Ontario program in Long Term Care
and in the Community.
3. $45,636 to St. Josephs Health Care Guelph to enhance the
Nurse Led Outreach program.
4. $69,700 to Canadian Mental Health Association Waterloo
Wellington Dufferin (CMHA WWD) additional case
management capacity to facilitate discharge planning and
access to community-based supports

16.0 2015/16 Annual Business Plan Dashboard


H. Blackett provided the Board an overview and recommendation of the proposed 201516Annual Business Plan (Annual Plan) Dashboard.
Motion No. 74-14/15 Moved by M. Basi, seconded by J. Nesbitt and unanimously
approved:
THAT the WWLHIN Board of Directors endorse the proposed
2015/16 Annual Plan Dashboard with direction to staff to refine the
plan and dashboard based on the finalized MLPA 2015/16.

WWLHIN Board of Directors


March 26, 2015

Page 6

17.0 IHSP Development Process


H. Blackett and S. Oakley presented the Board with an update on the progress to date for
the development of the Waterloo Wellington LHINs 2016-2019 Integrated Health Service
Plan (IHSP).
18.0 Next Meeting
Thursday, May 28, 2015
12:00-5 p.m. (WW LHIN Office)
19.0 Adjourn
Motion No. 75 -14/15 Moved by B. Larkin, seconded by J. Nesbitt and unanimously
approved:
On a motion by D. Small, seconded and there being no further business, the meeting
adjourned at 4:00 p.m.

__________________
J. Fisk
Chair

_
M. OBrien
Secretary

__

____________________
D. Ruprecht
Recording Secretary

Chairs REPORT

Consent Agenda
item 7.0 B

May 28, 2015


On April 10, 2015, I had the pleasure of joining senior staff from the Waterloo Wellington LHIN to hear
our recently appointed Board member Bryan Larkin deliver a keynote address on leadership. It was
refreshing to hear him speak so passionately about how we need to invest in our next generation of
leaders people who are going to help shape the future and continue to build the strong community we
have today. He also spoke of collaboration and how fortunate we are in Waterloo Wellington to have a
collaborative approach to dealing with issues. This is certainly a critical focus for us at the WWLHIN as
we continue to lead efforts to improve health for all our residents knowing we cant do that work alone.
Building on the theme of collaboration, on April 17th, 2015 the Waterloo Wellington LHIN welcomed a
delegation from the Ministry of Health and Long-Term Care including: Dr. Bob Bell, Deputy Minister;
Sharon Lee Smith, Associate Deputy Minister, Policy and Transformation; Susan Fitzpatrick, Associate
Deputy Minister, Delivery and Implementation; Nancy Naylor, Assistant Deputy Minister, Health System
Accountability and Performance Division; and Patrick Dicerni, Director, Policy and Delivery. We were
also joined by Brian Cowan, Chair of the Waterloo Wellington Community Care Access Centre. The
meeting was hosted at Langs Community Centre where we had a very engaging day of conversations
around all the innovative things happening in healthcare in our region. Aside from being impressed with
all the great work taking place in our LHIN, Dr. Bell was pleased to see that we have very positive
relationships with our health partners and system governors like Brian. Collaboration is absolutely
essential to achieving the priorities the provincial government has set and our own local priorities
developed with input from our health service providers, residents and community groups. What Dr. Bell
and his associates witnessed on that Friday April 17th was an example of true community building.
I want to acknowledge St. Marys Hospital in Kitchener for hosting a very informative event on women
and philanthropy following on the heels of a TD report on the state of philanthropy in Canada. More
women are making decisions on giving than ever before. This is certainly a positive trend and I cant help
but think this trend will change the philanthropy landscape in hospitals.
Finally, I am pleased to welcome our newest member of the Waterloo Wellington LHIN Board Michael
Delisle. Michael is currently the CEO of The Registrar Company, an ASQ National Accreditation Board
(ANAB) accredited Registration business with offices in Guelph and Dallas. Most recently, Michael was
Chair of the Board of Directors for the Waterloo Wellington Community Care Access Centre (CCAC)
where he was a Director for the past six years. Mikes experience and leadership in Waterloo Wellington
governance is a welcome addition to our Board. We look forward to working with Michael as we lead a
high-quality, integrated system for our residents.

Consent Agenda
item 7.0 C

Date: May 28, 2015


Vision : Better Health Better Futures
Mission: To lead a high-quality, integrated health system for our residents

Building a stronger community together


At a leadership event in April, Bryan Larkin, Chief of Waterloo Region Police and Waterloo Wellington LHIN
Board member delivered an inspiring keynote address that reminded us of the importance of building a
stronger community by investing in the next generation. He also reminded us that we do have much to
celebrate in Waterloo Region and that our community has a strong legacy of leadership and innovation.
At the Waterloo Wellington LHIN, leadership and innovation are the hallmark of our work as we strive every
day to transform our health system to one that is accessible, integrated and results-driven. This work does
not happen in isolation. It takes collaboration and a will to make things better. This is truly one of the
cornerstones of our community the ability to work together, share ideas and turn system thinking and
innovation into action.
We, as a community, need to have a bold vision for the future. It starts with good leadership. And as
Bryan reminded us we all have a responsibility to pay it forward.
Building a more equitable health system
Many of us are fortunate to have access to the health services we need. But what about individuals in our
community who are not so fortunate those who are more vulnerable and experience cultural/linguistic and
other barriers to access? Can we say the health system we have is truly equitable for all?
A report by the Association of Health Centres called: Towards Equity in Access to Community-based
Primary Health Care: A Population Needs-Based Approach, defines equity as a judgment about fairness.
We, who are charged with the responsibility of improving the local health system, must take into account
the different health needs and the multiple barriers to access to healthcare often experienced by diverse
population groups across geographic regions of Ontario.
Here are a couple ways we are addressing the health equity gap among some of our population using
diabetes services as an example.
Diabetes is one of the fastest growing diseases among the Aboriginal populations in Canada. In Ontario,
the prevalence of diabetes within the Aboriginal community is three times that in non-Aboriginal residents.
According to the Aboriginal culture, the education and self-management of the disease requires a very
different approach from the general population. In order to meet this pressing need, an Aboriginal diabetic
education and management program will be offered in our area very soon. This will be a full fledge diabetic
1

education/self- management program that will be delivered in accordance with the cultural beliefs of our
diverse aboriginal community.
This will be welcome news for people like 53-year old Peter who has problems with his feet related to his
diabetes. Peter, who has deep respect for traditional ways, will be able to get the help he needs that is
culturally appropriate.
The aboriginal program is led by the Aboriginal Health and Wellness program at Kitchener Downtown
Community Health Centre and will be delivered in Kitchener, Guelph and North Wellington.
The percentage (prevalence) of diabetes among the French-speaking community is also higher than the
general population. To meet the needs of the community, our French Language Services Coordinator
France Tolhurst was successful in working with Langs Community Health Centre in Cambridge to establish
a partnership with members of our Francophone Community in Hamilton to access a French language
diabetes education session series (through Langs) via the Onatario Telemedicine Network for our local
French speaking residents who have diabetes. One session took place at the end of March and two more
sessions are planned for June and September. The program could be expanded at other locations within
Waterloo Wellington to respond to the demands from other areas.
Another new innovative program in French has been developed in partnership with the Waterloo
Wellington LHIN and the Canadian Mental Health Association Waterloo Wellington Dufferin. The program
features a series of workshops on suicide prevention for the community, service providers and those in
education. Yet another example of collaboration leading to great outcomes for our diverse communities
and addressing prevelant gaps in health equity.
We are working hard to ensure our health system is one that is truly accessible to everyone while
recognizing the way people access health services may be different depending on the unique needs of
individuals. As we develop our next Integrated Health Service Plan access to health services from the
perspective of health quity will be an increasingly strong focus for us.

50 Sportsworld Crossing
In addition to our new Senior Director of Health Service Integration, Gloria Cardoso, we welcomed several
new faces to our LHIN dynamic team as we shift from contract to more permanent staff role. David Meyer,
Manager, Contracts and Accountability. David brings a broad range of expertise most recently as Manager,
Capital Projects at the Ministry of Research and Innovation. Jenny Flagler-George, Senior Planner has
joined us to cover Hilary Blacketts maternity leave. Jenny worked with a number of groups locally,
including the Manulife Centre for Community Health Research, Age Friendly City Committee for the City of
Waterloo, the Social Planning Council in KW, and the Canadian Council of Muslim Women. Cheryl Evans,
Communications Lead has joined us for a one-year secondment from Grand River Hospital. Cheryl is an
award-winning communications officer with 10+ years of health care experience and accredited with the
Health Care Public Relations Association. Karen Bell, Senior Manager, Health System Integration has

joined us from Grand River Hospital where she was Program Director of the Emergency Department and
lead the performance improvement of GRHs ED wait times. Karen has also worked within a professional
consulting firm focused on ehealth solutions and is a keen advocate to in the use of information and
information systems to help inform decision making. Brian Bailey recently moved to the Performance &
Accountability Department. Brian will continue to support his current area of performance analysis. The
Performance & Accountability team mandate is to ensure that health care dollars are spent efficiently and
effectively, yielding the best results possible for our residents.

WATERLOO WELLINGTON LOCAL HEALTH INTEGRATION NETWORK


Finance and Audit Committee
SUMMARY REPORT
TO
BOARD OF DIRECTORS

Consent Agenda
item 7.0 D

DATE: March 26, 2015


From: J. Fisk, Acting Chair of Finance and Audit Committee
D. Small absent
______________________________________________________________________
Report of The Finance and Audit Committee, which met on Thursday, March 26, 2015.
New Business
Q3 2014-15 Risk Summary Report
Z. Danis provided an update to the Finance and Audit Committee including details
pertaining to items removed from the previous risk report. Staff will continue to present a
Risk Summary report to the Finance and Audit Committee on a quarterly basis.
WWLHIN Corporate Insurance Coverage
Z. Danis updated the Finance and Audit Committee on the Waterloo Wellington LHINs
Corporate Insurance Coverage.
Q3 2014-15 Operations Financial Report
S. Heide presented the Operations Financial Report for Q3 2014 2015 to the Finance
and Audit Committee for review, as per section 2.3 of the Financial Statements,
Financial Management and Reporting mandate of the committee.
Motion No. FAC 22 -14

Moved by B. Dinwoody
Seconded J. Fisk (adopted)
THAT the Finance & Audit Committee make a
recommendation to the WWLHIN Board of
Directors to accept the Financial Statements ending
December 31, 2014.

2015/16 Operating Budget


Z. Danis presented the WWLHIN Operating Budget for fiscal year 2015/16 for
recommendation to the Board.
Motion No. FAC 23 -14

Moved by B. Dinwoody
Seconded M. OBrien (adopted)
THAT the Finance and Audit Committee
recommend that the Board approve the WWLHIN
2015/16 Operating Budget pending confirmation of
Page 1 of 2

funding from the Ministry of Health and Long-Term


Care.

Recommendation
THAT the Board receive this report of the Finance & Audit Committee meeting
held on January 29, 2015 for information

Page 2 of 2

Consent Agenda
item 7.0 E

WATERLOO WELLINGTON LOCAL HEALTH INTEGRATION NETWORK


Governance Committee
SUMMARY REPORT
TO
BOARD OF DIRECTORS
DATE: March 26, 2015
From: M. Basi, Chair of Governance Committee
____________________________________________________________________________
The Governance Committee met on Thursday, March 26, 2015 at 10:30 a.m. The agenda for
the Committee continues to be based on the Work Plan.
Governance Work Plan Refresh
There was a fulsome update and discussion on the Governance Engagement sessions planning
call on March 12th which included input from volunteer Health Service Provider Governors. The
HSP Governor planning group will continue to develop a plan for the Governance Engagement
sessions.
The Communications team provided the Governance Committee with an update on the
Governor stories underway for the profile section of the WWLHIN website. There was also a
fulsome discussion on the communication strategy for Health Service Provider Governors.
There was a fulsome discussion on The Work Plan which will be updated based on Committee
discussion.
Board Evaluation Summary
J. Fisk provided the Governance Committee with an update on the Board Evaluation Summary
results and noted that the feedback for improvement/opportunity areas will be discussed at a
future Board Education session. J. Fisk also provided the Committee with a status update on
the 3 year evaluation process underway for all LHINs collectively.
Public and HSP Participation at Board Meetings
There was a fulsome discussion of the guidelines for Public Participation at Board Meetings and
how to address Health Service Providers requests for participation. The Governance Committee
requested that staff develop a proposal to be reviewed at the next Governance Committee
meeting.
Recommendation
THAT the Board receive this report of the Governance Committee meeting held on March 26,
2015 for information.

Page 1 of 1

Consent Agenda item 7.0 F

Financial statements of

Waterloo Wellington Local


Health Integration Network
March 31, 2015

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
March 31, 2015
Table of contents
Independent Auditors Report ............................................................................................................................ 1-2

Statement of financial position .............................................................................................................................. 3

Statement of operations ........................................................................................................................................ 4

Statement of change in net debt ........................................................................................................................... 5

Statement of cash flows ........................................................................................................................................ 6

Notes to the financial statements ..................................................................................................................... 7-13

FOR DISCUSSION PURPOSES ONLY

Deloitte LLP
5140 Yonge Street
Suite 1700
Toronto ON M2N 6L7
Canada
Tel: 416-601-6150
Fax: 416-601-6151
www.deloitte.ca

Independent Auditors Report


To the Members of the Board of Directors of the
Waterloo Wellington Local Health Integration Network
We have audited the accompanying financial statements of Waterloo Wellington Local Health Integration
Network, which comprise the statement of financial position as at March 31, 2015, and the statements of
operations, change in net debt and cash flows for the year then ended, and a summary of significant
accounting policies and other explanatory information.
Managements Responsibility for the Financial Statements
Management is responsible for the preparation and fair presentation of these financial statements in
accordance with Canadian public sector accounting standards, and for such internal control as
management determines is necessary to enable the preparation of financial statements that are free from
material misstatement, whether due to fraud or error.
Auditors Responsibility
Our responsibility is to express an opinion on these financial statements based on our audit. We
conducted our audit in accordance with Canadian generally accepted auditing standards. Those standards
require that we comply with ethical requirements and plan and perform the audit to obtain reasonable
assurance about whether the financial statements are free from material misstatement.
An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in
the financial statements. The procedures selected depend on the auditors judgment, including the
assessment of the risks of material misstatement of the financial statements, whether due to fraud or error.
In making those risk assessments, the auditor considers internal control relevant to the entitys preparation
and fair presentation of the financial statements in order to design audit procedures that are appropriate in
the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entitys
internal control. An audit also includes evaluating the appropriateness of accounting policies used and the
reasonableness of accounting estimates made by management, as well as evaluating the overall
presentation of the financial statements.
We believe that the audit evidence we have obtained in our audit is sufficient and appropriate to provide a
basis for our audit opinion.

FOR DISCUSSION PURPOSES ONLY

Opinion
In our opinion, the financial statements present fairly, in all material respects, the financial position of
Waterloo Wellington Local Health Integration Network as at March 31, 2015 and the results of its
operations, change in its net debt, and its cash flows for the years then ended in accordance with Canadian
public sector accounting standards.

Chartered Professional Accountants, Chartered Accountants


Licensed Public Accountants
_________, 2015

Page 2

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Statement of financial position
as at March 31, 2015

Financial assets
Cash
Due from Ministry of Health and Long-Term Care (Note 9)
Other receivables

Liabilities
Accounts payable and accrued liabilities
Due to Ministry of Health and Long-Term Care (Note 3b)
Due to Health Service Providers (HSPs) (Note 9)
Due to the Local Health Integration Networks Shared
Services Office (Note 4)
Deferred capital contributions (Note 5)

Net debt

2015
$

2014
$

421,932
5,546,146
306,375
6,274,453

844,942
2,378,472
124,090
3,347,504

542,072
248,355
5,546,146

667,663
334,506
2,378,472

4,308
249,620
6,590,501

89
252,488
3,633,218

(316,048)

(285,714)

66,428
249,620
316,048
-

33,226
252,488
285,714
-

Commitments (Note 6)
Non-financial assets
Prepaid expenses
Tangible capital assets (Note 7)
Accumulated surplus
Approved by the Board

___________________________________ Board Chair

___________________________________ Finance and Audit Committee Chair

The accompanying notes to the financial statements are an integral part of this financial statement.
Page 3

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Statement of operations
year ended March 31, 2015

Revenue
Ministry of Health and Long-Term Care funding
Health Service Providers transfer payments
(Note 9)
Local Health Integration Network
operations - general and administrative
Project Initiatives (Note 10)
Diabetes Regional Coodination (Note 10a)
Enabling Technologies ETI PMO (Note 10b)
Emergency Department Lead (Note 10c)
Emergency Department/Alternative Levels
of Care Lead (Note 10d)
Aboriginal Planning (Note 10e)
French Language Services (Note 10f)
Critical Care Lead (Note 10g)
Primary Care Lead (Note 10h)
Amortization of deferred capital contributions
(Note 5)
Funding repayable to Ministry of Health and
Long-Term Care (Note 3b)

Expenses
Transfer payments to Health Service Providers
(Note 9)
Local Health Integration Network operations general and administrative (Note 11)
Proejct Initiatives (Note 10)
Diabetes Regional Coordination (Note 10a)
Enabling Technologies ETI PMO (Note 10b)
Emergency Department Lead (Note 10c)
Emergency Department/Alternative Levels
(Note 10d)
Aboriginal Planning (Note 10e)
French Language Services (Note 10f)
Critical Care Lead (Note 10g)
Primary Care Lead (Note 10h)
Annual surplus and accumulated surplus,
end of year

Budget
(Note 8)
$

2015
Actual
$

2014
Actual
$

1,007,340,276

1,035,139,980

1,021,950,105

4,107,342

4,107,343

4,173,795

1,057,284
510,000
75,000

1,057,284
510,000
75,000

1,341,284
280,000
75,000

100,000
5,000
106,000
75,000
75,000

100,000
5,000
106,000
75,000
75,000

100,000
5,000
106,000
75,000
75,000

94,245
1,013,545,147

94,245
1,041,344,852

81,134
1,028,262,318

1,013,545,147

(248,355)
1,041,096,497

(478,506)
1,027,783,812

1,007,340,276

1,035,139,980

1,021,950,105

4,201,587

4,085,542

4,243,669

1,057,284
510,000
75,000

985,524
454,095
75,000

998,133
171,752
66,661

100,000
5,000
106,000
75,000
75,000
1,013,545,147

100,000
924
105,432
75,000
75,000
1,041,096,497

100,000
360
106,000
72,132
75,000
1,027,783,812

The accompanying notes to the financial statements are an integral part of this financial statement.
Page 4

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Statement of change in net debt
year ended March 31, 2015
Budget
(Note 8)
$
Annual surplus
Change in prepaid expenses, net
Acquisition of tangible capital assets
Amortization of tangible capital assets
Decrease (increase) in net debt
Net debt, beginning of year
Net debt, end of year

(91,377)
94,245
2,868
(285,714)
(282,846)

2015
$
(33,202)
(91,377)
94,245
(30,334)
(285,714)
(316,048)

2014
$
26,417
(52,268)
81,134
55,283
(340,997)
(285,714)

The accompanying notes to the financial statements are an integral part of this financial statement.
Page 5

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Statement of cash flows
year ended March 31, 2015

Operating activities
Annual surplus
Less: items not affecting cash
Amortization of tangible capital assets
Amortization of deferred capital contributions (Note 5)

2015
$

2014
$

94,245
(94,245)
-

81,134
(81,134)
-

(3,167,674)
(182,285)
(125,591)
(86,151)
3,167,674

(2,378,472)
(67,959)
(5,412)
(35,341)
2,378,472

4,219
(33,202)
(423,010)

(35,361)
26,417
2,260,816

Acquisition of tangible capital assets

(91,377)

(52,268)

Financing activity
Capital contributions received (Note 5)

91,377

52,268

(423,010)
844,942
421,932

(117,656)
962,598
844,942

Changes in non-cash operating items


Due from Ministry of Health and Long-Term Care
Increase in other receivables
Accounts payable and accrued liabilities
Due to Ministry of Health and Long-Term Care
Due to Health Service Providers (HSPs)
Due to Local Health Integration Networks
Shared Services Office
Prepaid expenses

Net decrease in cash


Cash, beginning of year
Cash, end of year

The accompanying notes to the financial statements are an integral part of this financial statement.
Page 6

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Notes to the financial statements
March 31, 2015
1.

Description of business
The Waterloo Wellington Local Health Integration Network was incorporated by Letters Patent on
June 2, 2005 as a corporation without share capital. Following Royal Assent to Bill 36 on March 28,
2006, it was continued under the Local Health System Integration Act, 2006 (the Act) as the Waterloo
Wellington Local Health Integration Network (the LHIN) and its Letters Patent were extinguished. As an
agent of the Crown, the LHIN is not subject to income taxation.
The LHIN is, and exercises its powers only as, an agent of the Crown. Limits on the LHINs ability to
undertake certain activities are set out in the Act.
The mandates of the LHIN are to plan, fund and integrate the local health system within its geographic
area. The LHIN spans carefully defined geographical areas and allows for local communities and health
care providers within the geographical area to work together to identify local priorities, plan health
services and deliver them in a more coordinated fashion. The LHIN covers all of the County of
Wellington, the Region of Waterloo, and the City of Guelph. The LHIN also contains part of Grey County,
which is split with the South West and the North Simcoe Muskoka LHINs. The LHIN enters into service
accountability agreements with health service providers.
The LHIN is funded by the Province of Ontario in accordance with the Ministry LHIN Performance
Agreement (MLPA), which describes budget arrangements established by the Ministry of Health and
Long-Term Care (MOHLTC) and provides the framework for the LHIN accountabilities and activities.
These financial statements reflect agreed funding arrangements approved by the MOHLTC. The LHIN
cannot authorize an amount in excess of the budget allocation set by the MOHLTC.
The LHIN assumed responsibility to authorize transfer payments to Health Service Providers (HSPs),
effective April 1, 2007. The transfer payment amount is based on provisions associated with the
respective HSPs Accountability Agreement with the LHIN. Throughout the fiscal year, the LHIN
authorizes and notifies the MOHLTC of the transfer payment amount; the MOHLTC, in turn, transfers
the amount directly to the HSP. The cash associated with the transfer payment does not flow through
the LHIN bank account.
Commencing April 1, 2007, all funding payments to LHIN managed HSPs in a LHIN geographic area,
have flowed through each LHINs financial statements. Funding allocations from the MOHLTC are
reflected as revenue and an equal amount of transfer payments to authorized HSPs are expensed in
each LHINs financial statements for the year ended March 31, 2015.
The LHIN statements do not include any Ministry managed programs.

2.

Significant accounting policies


The financial statements of the LHIN are the representations of management, prepared in accordance
with Canadian public sector accounting standards. Significant accounting policies adopted by the LHIN
are as follows:
Basis of accounting
Revenues and expenses are reported on the accrual basis of accounting. The accrual basis of
accounting recognizes revenues in the fiscal year that the events giving rise to the revenues occur and
they are earned and measurable; expenses are recognized in the fiscal year that the events giving rise
to the expenses are incurred, resources are consumed, and they are measurable. Through the accrual
basis of accounting, expenses include non-cash items such as the amortization of tangible
capital assets.

Page 7

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Notes to the financial statements
March 31, 2015
2.

Significant accounting policies (continued)


Government transfer payments
Government transfer payments from the MOHLTC are recognized in the financial statements in the year
in which the payment is authorized and the events giving rise to the transfer occur, performance criteria
are met, and reasonable estimates of the amount can be made.
Certain amounts, including transfer payments from the MOHLTC, are received pursuant to legislation,
regulation or agreement and may only be used in the conduct of certain programs or in the completion of
specific work. Funding is only recognized as revenue in the fiscal year the related expenses are incurred
or services performed. In addition, certain amounts received are used to pay expenses for which the
related services have yet to be performed. These amounts are recorded as payable to the MOHLTC at
period end.
Deferred capital contributions
Any amounts received that are used to fund capital assets, are recorded as deferred capital
contributions and are recognized as revenue over the useful life of the asset reflective of the provision of
its services. The amount recorded under revenue in the statement of operations, is in accordance with
the amortization policy applied to the related tangible capital asset recorded.
Tangible capital assets
Tangible capital assets are recorded at historic cost. Historic cost includes the costs directly related to
the acquisition, design, construction, development, improvement or betterment of capital assets. The
cost of tangible capital assets contributed is recorded at the estimated fair value on date of contribution.
Fair value of contributed tangible capital assets is estimated using the cost of asset or, where more
appropriate, market or appraisal values. Where an estimate of fair value cannot be made, the tangible
capital asset would be recognized at nominal value.
Maintenance and repair costs are recognized as an expense when incurred. Betterments or
improvements that significantly increase or prolong the service life or capacity of a tangible capital asset
are capitalized. Computer software is recognized as an expense when incurred.
Tangible capital assets are stated at cost less accumulated amortization. Tangible capital assets are
amortized over their estimated useful lives as follows:
Computer equipment, furniture and fixtures
Leasehold improvements
Office equipment

3 years straight-line method


Life of lease straight-line method
5 years straight-line method

For assets acquired or brought into use during the year, amortization is provided for a full year.
Segment disclosures
A segment is defined as a distinguishable activity or group of activities for which it is appropriate to
separately report financial information. Management has determined that existing disclosures in the
statement of operations and within the related notes for both the prior and current year sufficiently
disclose information of all appropriate segments and, therefore, no additional disclosure is required.
Use of estimates
The preparation of financial statements in conformity with Canadian public sector accounting standards
requires management to make estimates and assumptions that affect the reported amount of assets and
liabilities, the disclosure of contingent assets and liabilities at the date of the financial statements and the
reported amounts of revenues and expenses during the reporting period. Significant items subject to
such estimates and assumptions include valuation of accrued liabilities and useful lives of the tangible
capital assets. Actual results could differ from those estimates.

Page 8

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Notes to the financial statements
March 31, 2015
3.

Funding repayable to the MOHLTC


In accordance with the MLPA, the LHIN is required to be in a balanced position at year end. Thus, any
funding received in excess of expenses incurred, is required to be returned to the MOHLTC.
a)

b)

The amount repayable to the MOHLTC related to current year activities is made up of the following
components:
Funding
received
$

Eligible
expenses
$

2015
Funding
excess
$

2014
Funding
excess
$

Transfer payments to HSPs


1,035,139,980
LHIN operations
4,201,588
Diabetes Regional Coordination
Centre
1,057,284
Enabling Technologies
510,000
Critical Care Lead
75,000
Emergency Department Lead
75,000
Emergency Department/Alternative
Levels of Care Lead
100,000
Aboriginal Planning
5,000
French Language Services
106,000
Primary Care Lead
75,000
1,041,344,852

1,035,139,980
4,085,542

116,046

11,260

985,524
454,095
75,000
75,000

71,760
55,905
-

343,151
108,248
2,868
8,339

100,000
924
105,432
75,000
1,041,096,497

4,076
568
248,355

4,640
478,506

The amount due to the MOHLTC at March 31 is made up as follows:


2015
$
Due to MOHLTC, beginning of year
Paid to MOHLTC during year
Funding repayable to the MOHLTC related to current
year activities (Note 3a)
Due to MOHLTC, end of year

4.

2014
$

334,506
(334,506)

369,847
(513,847)

248,355
248,355

478,506
334,506

Related party transactions


LHIN Shared Services Office, Local Health Integration Network Collaborative
The LHIN Shared Services Office (the LSSO) and the Local Health Integration Network Collaborative
(the LHINC) are divisions of the Toronto Central LHIN and are subject to the same policies, guidelines
and directives as the Toronto Central LHIN. The LSSO, on behalf of the LHINs is responsible for
providing services to all the LHINs. The full costs of providing these services are billed to all the LHINs.
Any portion of the LSSO operating costs overpaid (or not paid) by the LHINs at the year end are
recorded as a receivable (payable) from (to) the LSSO. This is all done pursuant to the shared service
agreement the LSSO has with all the LHINs.

Page 9

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Notes to the financial statements
March 31, 2015
4.

Related party transactions (continued)


The LHINC was formed in fiscal 2011 to strengthen relationships between and among health service
providers, associations and the LHINs, and to support system alignment. The purpose of LHINC is to
support the LHINs in:
Fostering engagement of the health service provider community in support of collaborative and
successful integration of the health care system;
Their role as system manager;
Where appropriate, the consistent implementation of provincial strategy and initiatives;
The identification and dissemination of best practices.
LHINC is a LHIN-led organization and accountable to the LHINs. LHINC is funded by the LHINs with
support from the MOHLTC.
Enabling Technologies for Integrated Project Management Office
Effective January 31, 2014, the LHIN entered into an agreement with Erie St. Clair, Hamilton Niagara
Haldimand Brant and South West (the Cluster) in order to enable the effective and efficient delivery of
e-health programs and initiatives within the geographic area of the Cluster. Under the agreement,
decisions related to the financial and operating activities of the Enabling Technologies for Integration
Project Management Office are shared. No LHIN is in a position to exercise unilateral control.
The MOHLTC provided the South West LHIN with $2,040,000 (2014 - $2,320,000) related to Enabling
Technologies initiatives. The South West LHIN flowed $510,000 (2014 - $280,000) of the funding to the
Waterloo Wellington LHIN.

5.

Deferred capital contributions


2015
$
Balance, beginning of year
Capital contributions received during the year
Amortization for the year

6.

252,488
91,377
(94,245)
249,620

2014
$
281,354
52,268
(81,134)
252,488

Commitments
The LHIN has commitments under various operating leases and maintenance contracts related to
building, software and equipment. Lease renewals are likely. Minimum lease payments due in each of
the next five years are as follows:
$
2016
2017
2018
2019
2020
Thereafter

334,982
311,380
311,380
311,380
77,845
-

The LHIN also has funding commitments to HSPs associated with accountability agreements. The
actual amounts which will ultimately be paid are contingent upon actual LHIN funding received from the
MOHLTC.
Page 10

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Notes to the financial statements
March 31, 2015
7.

Tangible capital assets

Office equipment, furniture


and fixtures
Computer equipment
Leasehold improvements

8.

Cost
$

Accumulated
amortization
$

2015
Net book
value
$

2014
Net book
value
$

362,261
85,467
358,650
806,378

347,296
83,233
126,229
556,758

14,965
2,234
232,421
249,620

56,478
3,439
192,571
252,488

Budget figures
The budget figures reported in the statement of operations reflect the initial budget at April 1, 2014 as
approved by the LHIN Board. The figures have been reported for the purposes of these statements to
comply with PSAB reporting requirements. During the year the government approved budget
adjustments. The following reflects the adjustments for the LHIN during the year:
The final HSP funding budget of $1,035,139,980 is derived as follows:

$
Initial budget
Additional funding received during the year
Final budget

1,007,340,276
27,799,704
1,035,139,980

The final LHIN general and administrative and specific initiatives budget of $6,204,871 is derived as
follows:
$
Initial budget
Additional funding received during the year
Amount treated as capital contributions made during the year
Final budget

6,296,248
(91,377)
6,204,871

Page 11

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Notes to the financial statements
March 31, 2015
9.

Transfer payments to HSPs


During the year, the LHIN was authorized to allocate funding of $1,035,139,980 (2014 - $1,021,950,105)
to the various HSPs in its geographic area. Actual transfer payments to the various sectors in fiscal 2015
as follows:

Operations of hospitals
Grants to compensate for municipal taxation public hospitals
Long-term care homes
Community care access centre
Community support services
Assisted living services in supportive housing
Community health centres
Community mental health programs
Specialty psychiatric hospitals
Addictions programs

2015
$

2014
$

591,089,080

592,553,624

159,225
178,940,392
130,112,449
27,176,605
6,013,278
21,393,493
38,641,303
30,642,050
10,972,105
1,035,139,980

159,225
176,901,625
122,436,308
25,334,972
5,923,778
20,799,606
36,660,812
30,642,050
10,538,105
1,021,950,105

The LHIN receives funding from the MOHLTC and in turn allocates it to the HSPs. As at March 31,
2015, an amount of $5,546,146 (2014 - $2,378,472) was receivable from the MOHLTC and payable to
HSPs. These amounts have been reflected as revenue and expenses in the statement of operations and
are included in the table above.
10.

Project Initiatives
Separate funding amounts were received by the LHIN from MOHLTC for specific project initiatives.
These revenues and the associated expenses are classified by initiative in the Statement of operations.
The following table classifies the initiative expenses by object:

Salaries, benefits, and consulting services


Occupancy
Shared services
Public relations
Mail, courier, and telecommunications
Other

2015
$

2014
$

1,664,776
74,338
120,008
1,410
5,042
5,401
1,870,975

1,363,517
82,957
103,467
25,518
3,717
10,862
1,590,038

Diabetes strategy operational expenses included in the project initiative expenses above are as follows:

Salaries and benefits


Other expenses
One-time expense

2015
$

2014
$

857,288
128,236
985,524

799,082
199,052
32,533
1,030,667

Page 12

FOR DISCUSSION PURPOSES ONLY

Waterloo Wellington Local Health


Integration Network
Notes to the financial statements
March 31, 2015
11.

LHIN operations - general and administrative expenses


The statement of operations presents expenses by function. The following classifies general and
administrative expenses by object:

Salaries and benefits


Occupancy
Amortization
Shared Services
LHIN Collaborative
Public relations
Consulting services
Supplies
Board Chair per diems
All other board members per diems
Other governance costs
Mail, courier and telecommunications
Other

12.

2015
$

2014
$

2,579,361
215,822
94,245
283,655
47,500
129,647
271,347
67,888
65,975
26,550
53,023
44,148
206,381
4,085,542

2,843,504
230,213
81,134
308,951
36,743
38,686
142,928
45,784
66,500
34,925
45,343
39,512
329,446
4,243,669

Pension agreements
The LHIN makes contributions to the Hospitals of Ontario Pension Plan (HOOPP), which is a multiemployer plan, on behalf of approximately 35 members of its staff. The plan is a defined benefit plan,
which specifies the amount of retirement benefit to be received by the employees, based on the length
of service and rates of pay. The amount contributed to HOOPP for fiscal 2015 was $299,130 (2014 $276,881) for current service costs and is included as an expense in the statement of operations. The
last actuarial valuation was completed for the plan on December 31, 2014. At that time, the plan was
fully funded.

13.

Guarantees
The LHIN is subject to the provision of the Financial Administration Act. As a result, in the normal course
of business, the LHIN may not enter into agreements that include indemnities in favour of third parties,
except in accordance with the Financial Administration Act and the related Indemnification Directive.
An indemnity of the Chief Executive Officer was provided directly by the LHIN pursuant to the terms of
the Local Health System Integration Act, 2006 and in accordance with s. 28 of the Financial
Administration Act.

14.

Comparative figures
Certain comparative figures have been reclassified to conform with the financial statement presentation
adopted for the current year.

Page 13

FOR DISCUSSION PURPOSES ONLY