CEO REPORT TO THE BOARD

Mississauga Halton LHIN

February 2015
 Annual Business Plan Measurement and Notable Sector
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Priorities Performance Engagement

CONTENTS: The following is a compilation of the major activities/events undertaken during this
period in support of the Mississauga Halton LHIN’s Strategic Directions;
MINISTRY OF HEALTH AND LONG-TERM
CARE UPDATE 3 Accessible and Sustainable Health Care

 Improve access to services to improve consumer flow, quality and safety

 Support consumers, families and health care professionals to navigate the health care
ANNUAL BUSINESS PLAN PRIORITIES 2013/14 5
system
 Improve sustainability of the health care system
Highlights 6
Accessible and Sustainable Health Care 7
Family Health Care When You Need It
Family Health Care When You Need It 12
Enhanced Community Capacity 14  Improve access to family health care
Optimal Health – Mental and Physical 17  Increase linkages between family health care and other health care providers to improve
High Quality, Person-Centred Care 18
communication, coordination and integration across the continuum of care

Enhanced Community Capacity

MEASUREMENT AND PERFORMANCE 20
 Enable people to stay in their homes longer
Ministry-LHIN Performance Agreement Targets 20  Provide integrated services that bring care closer to home

Optimal Health – Mental and Physical

NOTABLE SECTOR ENGAGEMENT 23
 Increase healthy habits and prevention of disease
Accountability Agreements 24  Build partnerships for healthy communities
High Quality Person - Centred Care
COMMUNICATIONS 26
 Support and foster a quality culture across the continuum of care
 Value people’s experiences to support system improvement
 Apply a health equity lens for the delivery of health care services

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MINISTRY OF HEALTH AND LONG-TERM CARE UPDATES
Mental Health and Addictions
Mental Health and Addictions (MH&A) continues to be a major focus
for the Ministry of Health. A special advisory panel has been
constituted to provide advice to the Government on how to improve
MH&A services in the province. An update communications deck is
attached to this report (see attachment A) which contains a high level
review of the progress to date and near term priorities for the
Government. It also lists the members of the Panel. This information
was reviewed at the most recent LHIN CEO Council meeting and it
was agreed that the LHINs collectively need to determine how to
share best practice information for future investments in increased
MH&A services.
Fiscal Outlook
The LHIN CEOs received a briefing from the Ministry on the general
fiscal outlook for the province and the impact on the Ministry of
Health. Overall, the fiscal picture remains constrained for the next
two to three years. The Government is undertaking a full review of all
programs and services across all of the Provincial Government. There
is a continuing strong commitment to balancing the budget by 2017.
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In short this means a continuing commitment to focusing on increased
efficiencies as almost all new funding will be directed to new services
to meet growth pressures.
Deputy Minister Bob Bell Visit
On February 5, 2015, the Mississauga Halton LHIN in partnership
with Central West LHIN was pleased to invite health sector leaders
including members of the Community Capacity Steering Committee
to an evening with Dr. Bob Bell, Deputy Minister of Health and Long-
Term Care, and members of his senior leadership team including
Susan Fitzpatrick and Nancy Naylor. This important evening enabled
a meaningful exchange of ideas and information that highlighted the
challenges we collectively face when it comes to exponential growth
and capacity planning across local communities.
The following day, Dr. Bob Bell and members of his senior leadership
team had an opportunity to tour local health service provider India
Rainbow and then join us for the afternoon to learn about key
activities and achievements in our LHIN.
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Patients First: Action Plan

for Health Care
Government of Ontario's next
phase of its Action Plan for
Health Care, Patients First was
released by Minister of Health
and Long-Term Care Dr. Eric
Hoskins. The Patients First:
Ontario’s Action Plan for Health Care strengthens the province’s
commitment to put people and patients first by improving the health
care experience. The new plan outlines how the province will
increase access to better and more coordinated care, and ensure the
health care system is sustainable for generations to come.

This plan focuses on four key objectives:

 Access: Improve access – providing faster access to the right care.
 Connect: Connect services – delivering better coordinated and
integrated care in the community, closer to home.
 Inform: Support people and patients – providing the education,
information and transparency they need to make the right
decisions about their health.
 Protect: Protect our universal public health care system – making
decisions based on value and quality, to sustain the system for
generations to come.

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PROGRESS ON ANNUAL BUSINESS PLAN PRIORITIES 2014/15

 ACCESSIBLE AND SUSTAINABLE HEALTH CARE

 FAMILY HEALTH CARE WHEN YOU NEED IT

 ENHANCED COMMUNITY CAPACITY

 OPTIMAL HEALTH – MENTAL AND PHYSICAL

 HIGH QUALITY PERSON-CENTRED CARE

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REPORT HIGHLIGHTS
 A successful Healthy Holidays initiative leads to LHIN year
round strategy named myhealth365.
 Congestive heart failure QBP work to conclude in spring 2015.
 Two IDEAS projects completed with remarkable improvement
noted
 Regional Rehabilitative Care Review Report - Phase One
finalized
 one-Link launched
 1949 hosted telemedicine events in Q2 with top 3 topics -
mental health, gynecology and primary care.
 A regional approach to the collection of delirium indicators for
hospitals being developed
 No Wrong Door launch March 2015 will celebrate early
adopters, share best practices and collaborate
 RM&R: THP to integrate Meditech with CHRIS for the Acute
to CCAC pathway - data flowing by March
 Primary Care Advisors set to support primary care with
navigation of the health system
 Primary Care Clinic Day is being planned for March 27, 2015
 an eCompendium is being developed to provide a listing of all
specialists practicing within the Mississauga Halton LHIN -
targeting 70% participation before launch
 81 Primary Care Providers and 17 specialists recruited for
eConsult initiative in the Mississauga Halton LHIN
 Trillium Health Partners and related system partners
Improving Transitions through Electronic Hospital and
Emergency Discharge Project received the Hazel McCallion
Award in Quality of Care for Sustained Improvement in
December 2014
 Halton Hills, Milton, South Etobicoke and South West
Mississauga Health Links have submitted business plans. East
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Engagement
Mississauga Health Link (early adopter) has enrolled 137
patients and data show reduction in ED visits and
hospitalizations
 Community Capacity Study: Meeting Senior Care Needs Now
and in the Future: A Community Capacity Plan for the
Mississauga Halton LHIN was released to steering committee
on February 13, 2015
 Caregiver Respite Program has completed the development of
targeted services and 2015/16 fiscal year will see refinement of
current processes
 Health Equity Inventory Survey results to be shared at Health
Equity Symposium on March 23, 2015
 Five-day Mental Health First Aid training course in French
held for a Francophone trainer
 The Mississauga Halton LHIN participated in the creation of
the "Coalition pour Aînés Francophones" de Peel-Halton
(CAF)
 All of the qualified Mississauga Halton LHIN organizations
targeted to implement IAR are now complete
 The completed Health Service Providers, Board approved
CAPS refresh, have been submitted for LHIN review
 Amended 2015/16 M-SAA include one (1) new indicator
related to Governance specified within Schedule E3
Performance Obligations
 The LHIN has already communicated its’ intent to enter into a
new H-SAA for the 2015/16 fiscal year
 The next Community Quarterly Sector Meeting will be held on
April 10, 2015
 The LHIN endorsed the CCAC to declare a priority status in
support of a regional hospital flow crisis related to hospital
patients waiting for long-term care beds.
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ACCESSIBLE AND SUSTAINABLE HEALTH CARE

Mississauga Halton LHIN Healthy Holiday Strategy Because of the uptake in the Mississauga Halton LHIN for the healthy
The regional Healthy Holidays initiative for 2014 has come to its holidays strategy, work is being done in partnership with Acclaim
conclusion post-holiday season. An initial evaluation of the Health and iamsick.ca for a year-round approach. The strategy will
communication strategy yielded positive results. The highlights were closely follow Ontario’s Patients First Action Plan for Health Care
as follows: with a strong focus on access, connection and information with high
• The iamsick.ca mobile app was used 1,992 times – Android quality person-centred care at the centre. The year-round strategy will
ranked #7 of Canadian Health apps and iPhone ranked #13 of be called myhealth365.
Canadian Health apps
• 976 visits to feelbetterfaster.iamsick.ca website
• 782 app downloads
• Clinics were engaged and updating their hours to reflect
changes in their schedules – even on Christmas day, and data
was immediately displayed in real-time on website and apps
• Received holiday information from 200 healthcare providers
• 394,500 social media views, shares, likes, visits of
Mississauga Halton LHIN Healthy Holidays tips and resources
in a 10-day span.

A sample of residents in the Mississauga Halton LHIN was engaged

to determine if the pilot project should continue. Residents reported
they felt like their feedback from earlier initiatives was heard. Of
note, residents appreciated that the information was correct, up-to-date
and that it was accessible on their smartphones where ever they were
during the holiday season.

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Health System Funding Reform (HSFR)
In the context of mobilizing effort to implement Health System
Funding Reform (HSFR), a regional group of health service providers
convenes at the HSFR Local Partnership Committee to discuss local
impacts, implications and risks associated with the implementation,
and related mitigation strategies for Quality Based Procedures
(QBPs). The Committee recommended a comprehensive work plan
for fiscal 2014/15 and 2015/16. The work plan encompasses several
areas of focus including:
• Evaluating the performance of all QBPs where clinical
handbooks exist;
• Informing volume management policy; and
• Knowledge transfer, including the integration of “Improving &
Driving Excellence Across Sectors (IDEAS)” locally.
In January 2015, hospital partners reported their progress to date for
both Congestive Heart Failure and Hip Fracture. Regional
improvement work related to congestive heart failure commenced in
September 2014 and will be concluded in early spring 2015, with the
system goal of improving a patient’s acute length of stay while in
hospital by implementing a consistent care pathway and physician
order sets for this patient cohort. The hip fracture QBP was identified
for regional improvement work in November 2014 and will continue
into 2015/16 with a focus on the patient’s journey from the emergency
to post-rehabilitation continuum in the community.
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Engagement
Improving and driving excellence across sectors (IDEAS) is a
provincial initiative, co-sponsored by Health Quality Ontario (HQO)
and the Institute for Health, Policy, Management and Evaluation at the
University of Toronto. IDEAS was initiated to complement the
implementation of HSFR, with the goal of introducing and sustaining
quality improvement science across Ontario. The Mississauga Halton
LHIN has had congestive heart failure commenced in September 2014
and will be concluded in early spring 2015, with two projects directly
related to HSFR implementation.
Two projects, Total Joint Replacement Ambulatory Rehabilitation,
and Stroke Rehabilitation were successfully completed with
remarkable improvement noted. Regional implementation continues
with respect Ambulatory Rehabilitation and Stroke care in our region.
Capital Developments
Trillium Health Partners Master Plan
The combined Stage 1 Proposal and Stage 2 Functional Program of
the proposed Courtyard Project was endorsed by the Mississauga
Halton LHIN Board on January 15, 2015. A letter to this effect was
provided to the Ministry of Health and Long-Term Care. Mississauga
Halton LHIN staff continue to work with Trillium Health Partners on
their review of the Stage 1 Master Plan submitted March 2014. Both
redevelopment proposals are not Ministry approved projects at this
point.
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Community Capital of the impact of adopting the Provincial Rehabilitative Care Alliance
An environmental scan of community-based hub models is under way Definitions Framework for Bedded Levels of Care was also
to inform the potential development of integrated community health completed.
hubs in Mississauga Halton. Mississauga Halton LHIN staff are
reviewing available data to determine areas of opportunity, with a The Rehab Care Alliance has been approved by the pan-LHIN CEOs
particular focus on health and social service needs, and will be to move forward on a second mandate, which will be implementation
looking to broader stakeholders engagement over the next several of the proposed Definitions Framework and articulation of a work
months. plan to advance this work. The LHIN will be awaiting these
recommendations to move forward in alignment with the provincial
Regional Program for Rehabilitative Care & Complex direction.
Continuing Care Services
The Mississauga Halton LHIN, in partnership with its health service
providers has worked towards developing a regional rehabilitative
strategy incorporating Rehabilitative Care Alliance directions, best
practices and stakeholder feedback to enhance patient access and flow
through the system, improve patient experience and outcomes, and
improve system integration.

Following the completion of phase one analysis of the current model

of delivery of Rehabilitative Care in the Mississauga Halton LHIN,
the Mississauga Halton Rehabilitative Care Steering Committee
finalized the Regional Rehabilitative Care Review Report - Phase One
in January 2015.

This report summarizes findings from a systematic review, secondary

data analyses (specifically focusing on stroke care within the LHIN as
a proxy), and stakeholder consultations, and proposes
recommendations for the development of a regional strategy based on
a best practices model for regional Rehabilitative Care. An analysis

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Enhancing Access to Mental Health and Addictions Services
Through the work of the Brand Workgroup and marketing group as
well as feedback and approval from the Steering Committee, the
System Access Model, referred to as SAM over the past year is now
officially one-Link.
Confidential referrals to the support
one-Link Shared Purpose
“Mississauga Halton LHIN’s one-Link enables equitable access and
coordinated care to make it possible for people to receive the right
addictions and mental health care, at the right time and in the right
place.”
Mississauga Halton LHIN Telemedicine Strategy
The Telemedicine Advisory Committee continues to meet to advance
its goal to increase the number of health service providers and clients
using telemedicine technologies to provide and access care. To date
we have 31 active sites and 64 active systems within the Mississauga
Halton LHIN. Second quarter reports indicate 1949 hosted events
(1391 clinical, 100 educational and 458 were administrative) with
February 2015
Notable Sector
Communications
Engagement
8678 participants. Of these events, the top three were mental health,
gynecology and primary care. The committee is looking to work with
OTN to review utilization and refresh local goals, work plan, and
committee membership to reflect the advances in telemedicine and the
enhanced collaboration with the Ontario Telemedicine Network
(OTN).
Seniors’ Strategy
The Seniors’ Strategy Steering Committee met in January to review
the Region of Peel Aging Population Terms of Council Priorities and
Halton Regions' Older Adult Plan. Results of the Collaborative
Community Capacity Study will be reviewed at the next meeting. The
results, along with Region reports and provincial reports will be used
to help determine the priorities for planning for care for seniors in our
communities. The Committee wants to ensure clear alignment with
various seniors' care plans.
The Senior Friendly Hospital Working Group continues to meet to
develop a regional approach to the collection of delirium indicators
for all hospitals within the Mississauga Halton LHIN.
The Specialized Geriatric Services program participated in a regional
planning day to determine priorities for Year 1. Planning day
observations and comments were captured and summarized to
determine how the regional program might fill identified gaps to
improve efficiencies.
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“Every Door is the Right Door” Service System
The Mississauga Halton LHIN System Integration Group for Mental
Health and Addictions (SIGMHA) has revised and updated the Every
Door is the Right Door or No Wrong Door (NWD) Protocol
document. The No Wrong Door Working Group will be developing a
NWD champion’s team, establish a charter of NWD member agencies
and plan a NWD launch celebrating early adopters, sharing best
practices and build collaborations.
ConnectingGTA
ConnectingGTA (cGTA) is a regional solution that supports the
delivery of provincial electronic health records by linking and
integrating electronic patient information from across the care
continuum and making it available at the point-of-care to improve the
patient and clinician experience.
ConnectingGTA is currently planning the first workshop with Wave 2
organizations. Project kick off invitations will be sent out mid
February and workshop invitations will follow in March. Halton
Healthcare Services will be participating as a data contributing
organization and we have four (4) other organizations within the
Mississauga Halton LHIN that will be receiving “view only” access to
the ConnectingGTA data.
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Communications
Engagement
Resource Matching and Referrals (RM&R) Cluster 2
The goal of the RM&R BTI program is to provide a way to streamline
the complex patient referral environment across Ontario.
Within the Mississauga Halton LHIN, Trillium Health Partners (THP)
and Halton Healthcare Services (HHS) are implementing the
Provincial Referral Standards (PRS). The PRS for Acute to LTC
(both hospitals) is complete; the PRS for Acute to Community Care
Access Centre (CCAC) HHS is complete.
THP has completed the work to integrate Meditech with CHRIS for
the Acute to CCAC pathway and data will begin to flow before the
end of February. The balance of work in this fiscal will be to
implement the PRS for Acute to Rehab/Complex Continuing Care
(CCC).
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FAMILY HEALTH CARE WHEN YOU NEED IT
Primary Care Integration Strategy
The Primary Care Integration strategy, designed to improve access to
primary care and increase linkages between primary care and other
health care providers, is working towards initiatives that will build
awareness of health care system resources and capacity within the
Primary Care sector.
Primary Care Advisors
The five Primary Care Advisors, who will be engaging with individual
Primary Care Providers in their office environments, are partaking in
an intensive orientation of the Mississauga Halton LHIN. To address
the needs of physicians effectively, they will need to be familiar with
the range of resources available. The PCAs have started limited
engagements with Primary Care Providers launching with “warm”
contacts that are familiar with the Primary Care Integration strategy.
The learning from this role is already becoming apparent as the
physicians ask questions seeking support in navigating. These
questions/requests for support have a wide range, including the
availability of needed services to clinical questions. Full launch of
this role into the broader community is planned for March 2015.
Primary Care Clinic Day
The second annual Primary Care Clinic Day is being planned for
March 27, 2015. Open to all Primary Care Providers across the LHIN
this event aims to increase capacity through clinical education
sessions, a health service provider information fair, an opportunity to
February 2015
Notable Sector
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Engagement
showcase regional programs and initiatives specifically targeting
Primary Care.
eCompendium of Specialty Care
In partnership with the Mississauga Halton CCAC, an eCompendium
is being developed to provide a listing of all specialists practicing
within the Mississauga Halton LHIN. This resource will support the
Primary Care Providers to make referrals to the appropriate specialist
with the necessary work up to enable the specialist to begin the
consultation immediately. The platform for the resource has been
developed within the Mississauga Halton CCAC’s HealthLine
website. The final step within this project is to populate the database
with content from the individual specialists’ practices targeting 70%
participation before launching the platform.
eConsult
Through the Ministry of Health and Long-Term Care’s Provincial
eConsult Initiative, the Mississauga Halton LHIN has partnered with
Champlain LHIN as their regional partner to further evaluate their
existing eConsult service model. The Mississauga Halton LHIN was
asked to recruit at least 50 Primary Care Providers and 4 specialties
within this pilot by December 2014. These targets were successfully
reached. Both primary care and specialty care providers continue to
register for the program with 98 physicians now engaged (81 Primary
Care and 17 Specialists). Ontario MD is conducting a baseline
assessment of physician practices related to consultations which will
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form the basis for the evaluation of the various models being review of patient and provider experiences with Health Links is
explored. nearing completion.

Primary Care Improving Transitions through Electronic
Hospital and Emergency Discharge
The improving transition through electronic hospital and emergency
discharge project aims to improve the communication process
between hospitals and primary care providers and the Mississauga
Halton Community Care Access Centre (CCAC) as soon as a patient
is admitted to the hospital or discharged from the hospital. This
project has come to completion. Trillium Health Partners and other
related system partners received the Hazel McCallion Award in
Quality of Care for Sustained Improvement regarding the
implementation of this project at Credit Valley Hospital in December
2014.
Hospital Report Manager (HRM) Implementation
OntarioMD's Hospital Report Manager (HRM) enables physicians
using EMRs to receive direct electronic hospital reports into their
patient's medical record within 30 minutes of transcription.
The implementation of HRM through the ConnectingGTA pathway
for Trillium Health Partners (THP) remains on hold. William Osler
Health System (WOHS) is currently testing their data feed to HRM
through ConnectingGTA and working through issues discovered in
the testing phase. By mid-February, we will have a better idea if
testing will resume for THP based on the success of WOHS.

Health Links
Health Links in Business Planning Phase
The LHIN has now received Business Plans from four Health Links:
Halton Hills, Milton, South Etobicoke and South West Mississauga
for review and submission to the Ministry of Health and Long-Term
Care. It is anticipated the remaining two health links, Oakville and
North West Mississauga will submit their business plans by the end of
February.

As of January 20, 2014, the East Mississauga Health Link (early

adopter) has enrolled 137 patients. Early quantitative data review
shows reductions in ED visits and hospital readmissions for
individuals served by the East Mississauga Health Link. A qualitative

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ENHANCED COMMUNITY CAPACITY

The Community Capacity Study Caregiver Respite Program
The Mississauga Halton and Central West Local Health Integration The Caregiver Respite Program is moving forward with its’ agenda.
Networks and Community Care Access Centres (CCACs) jointly The Caregiver Respite Program has completed the development of
contracted with Preyra Solutions Group to develop a community targeted services under the Program for this 2014/15 fiscal year (ie:
health services capacity plan for each LHIN to meet the needs of the short stay respite – two (2) beds funded at Oakville Seniors
LHINs' growing and aging populations. The objective of the study Residence; opening of evening respite hours at three (3) health service
was to evaluate the level and mix of health services required by the providers; utilization of educators to train caregivers; respite advisors
growing and aging populations in each LHIN, including a in place and part of Central Intake). The 2015/16 fiscal year will see
comprehensive assessment of current and future capacity and need for refinement of current processes including:
community-based health services for seniors. • intake and referral • integration of Adult Day Services
• booking into services into the full Respite Program
After extensive data analysis, review of other jurisdictions, and • use of Respite Advisors • development of the potential for
discussions with multiple organizations and stakeholders, the findings • coordination of educators overnight respite in Adult Day
from the study are almost ready to be shared. On November 18, over for in-home and in-class • plans for bringing the service
teaching of caregivers online with the Program and in
90 stakeholders gathered for the Community Capacity Study session.
• determination of funding what funding year
At the session, the consultant team reviewed the study results and allocation for the 15/16 • work and completion of the
asked for feedback from those in attendance to ensure that the most fiscal year Resource and Standards manuals.
important areas were adequately considered and to share further • booking of short stay
questions and discussion to further enrich the study and develop the respite
final report. A draft report has been shared with the Steering
Committee for review. The final report, Meeting Senior Care Needs Funding of short stay respite beds remains open for exploration if
Now and in the Future: A Community Capacity Plan for the other viable sites identified. The Program’s in-home respite service
Mississauga Halton LHIN was released to the steering committee on has a long wait list and will need discussion at the Steering Committee
February 13, 2015. for funding priority.

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Advancement of Community Practice

The Steering Committee is revising the Terms of Reference, finalizing
a Purpose Statement, and discussing needed actions in 2015/16.

The Committee has elected a new Chair and orientation will ensue.
All of the collaboratives are operational with five of the six having
extensive work completed. One collaborative is being highlighted in
this report (see below and Regional Learning Centre).

The ACP Coordinator is in place and developing a thorough

understanding of the initiative in order to provide support.

A Collaboratives Facilitator position was posted with recruitment

targeted for mid to late March. This position is the administrative
support for the ACP initiative and in particular the Collaboratives and
the Steering Committee.

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Mississauga Halton LHIN Regional Learning Centre Educational Update

Education Resource and Outcomes

Initiative
PSW Education PSW modules for the winter term (2015) are delivered 7 days per week
Update PSWs receive certificates and a resource folder for all modules attended
January 2015 courses included:
Infection Control, Professionalism, Safety & Risk, CPR
Number of Participants: 200+
Number of Health Service Providers: 9
Off-site Training: 2 off-site sessions delivered on Professionalism and Safety and Risk
February 2015
The Regional Learning Centre now has a Skills Lab for development and implementation of the following modules;
Personal Care, Lifts and Transfers
Gentle Persuasive Approaches (full course & refresher) and Cardiopulmonary Resuscitation- CPR
March 2015
Modules Include: Enhanced Skills, Medication Management, Gentle Persuasive Approaches, Mental Health, and
Documentation
Mental Health & Education Needs Assessment Survey created for Mental Health & Addictions Health Service Providers. The survey
Addictions will be complete in the spring of 2015.
Education Needs
Assessment
Building Regional Learning Centre technologies initiatives:
Technology 1. Survey Monkey
2. WebEx
3. Teleconferencing
4. iClickers
5. Eventbrite electronic registration.
6. Registered domain name www.mhlhinrlc.ca for future website development. Established @mhlhinrlc.ca email
address

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OPTIMAL HEALTH – MENTAL AND PHYSICAL

Regional Integrated Chronic Disease Prevention and

Management Strategy
The Mississauga Halton LHIN Chronic Disease Prevention &
Management (CDPM) Regional Advisory Working Group has created
an alignment model of provincial and regional initiatives that impact
and enable the work done in the CDPM portfolio. The working group
is in the process of creating a strategic plan report that will inform the
development of the operational plan for the 2015-2016 year. The
working group is also reviewing its Terms of Reference, electing new
co-chairs and engaging members from the community support sector
to provide feedback on the Mississauga Halton LHIN CDPM model
that was developed by the working group, and will look to the
community support sector on best practices to implement the model.

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HIGH QUALITY PERSON-CENTRED CARE

Mississauga Halton LHIN Health Equity community capacity for French Language Services within the
To aid in the development of understanding health inequities within Mississauga Halton LHIN by increasing the number of cultural and
Mississauga Halton, the Mississauga Halton System Planning linguistic appropriate education programs for Francophones.
Advisory Committee on Health Equity is participating in the
dissemination of a Health Equity Inventory Survey. The purpose of Francophone Community Engagement
this integral survey is twofold: The Mississauga Halton LHIN participated in the creation of the
1. To better understand the types of socio-demographic data "Coalition pour Aînés Francophones" de Peel-Halton (CAF) in
currently being collected by Health Service Providers and partnership with the Central West LHIN and Réflet Salveo. Members
Community Partners in Mississauga and Halton; and of this coalition are Francophone seniors groups and organizations
2. To establish a foundational framework based on the findings, providing services in French in the regions of Peel and Halton. The
which will help inform the development and implementation new group recognizes that each organization will keep its own
of a standardized data collection tool. mandate, structure and activities but it will provide the opportunity for
these organizations to work on common goals. The long-term goal is
Survey findings will be shared at the Health Equity Symposium on to create an Elderly Persons Centre that will coordinate a broad range
March 23, 2015. of French-Language programs and services. In the short term, the
coalition's priority is to improve access to activities available for
French Language Services (FLS)
Francophone seniors and promote existing programs and activities.
French Language Service Capacity
The Mississauga Halton LHIN provided a five-day Mental Health
First Aid training course in French for a Francophone trainer. The
trainer will then be able to provide training within the Francophone
community. This initiative was the result of a partnership between the
Canadian Mental Health Association (CMHA) Halton Region, the
Centre de services de santé de Peel and Halton (CSSPH-Francophone
community based organization) and the Mental Health Peel Services
collaborative for youth led by the Centre for Addictions and Mental
Health (CAMH). The overall goal of this project was to enhance the
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Community Care Information Management (CCIM) /Integrated

Assessment Record (IAR)
The strategic vision of Community Care Information Management
(CCIM) is to provide seamlessly-integrated, community-based client
care where all service providers can securely share and access
consistent and accurate information electronically. Assessment
projects include Integrated Assessment Record (IAR), Ontario
Common Assessment of Need (OCAN), Community Support Services
Common Assessment Project (CSS CAP) and InterRAI Community
Health Assessment (CHA). The Integrated Assessment Record (IAR)
is an application that allows authorized users to view a consenting
client’s assessment information to effectively plan and deliver
services to that client.

All of the qualified Mississauga Halton LHIN organizations targeted

to implement IAR are now complete. IAR, now in sustainment mode,
will work on reporting for the LHINs and support adoption where
possible.

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MEASUREMENT AND PERFORMANCE

Ministry-LHIN Performance Agreement (MLPA) Targets
The Mississauga Halton LHIN achieved the target within a 10%
corridor in 10 of 15 indicators with an average provincial rank of six
(previous 7) out of 14 LHINs.
Five (5) indicators, emergency department length of stay for admitted
patients, Magnetic Resonance Imaging (MRI), Computerized
Tomography (CT), Knee Surgery wait time and Repeat emergency
department visits for substance abuse, experienced performance
outside of the 10% corridor.
Repeat emergency department visit for substance abuse rate remained
stable over eight quarters at 25%. There are a number of LHIN-wide
Mental Health and Addiction strategies being developed to support
this patient cohort using a two-pronged approach:
1) Peer support infrastructure and development of programs and
services; and
2) Addictions, investing in the options for withdrawal
management including coordinating with cross-LHIN
residential withdrawal management; and community addiction
advisors working directly within the emergency department.

Based on increased and sustained emergency department demand at

both Halton Healthcare Services and Trillium Health Partners, and the
limited post-acute options available for transitioning patients from
hospital to Long-Term Care, a Priority 1A status was declared to
initiate crisis placement for medical and surgical patients in the
hospitals.

Both diagnostic indicators, CT and MRI continue to experience

exceptional growth and as a result, the wait times for low priority
procedures continue to increase. Initiatives are focused on improving
data quality for all priority levels and increasing hours by partnering
with the Regional Cancer Centre for additional support for oncology
patients.

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Provincial Quarter Actual Performance (Q3 2014/15)

Integration & Quality & Improved Health

Access to Health Care Services Coordination of Care Outcomes
ERLOS Surgical & Diagnostic Wait Times Repeat ED Visits
LHIN
Adm I-III IV-V Cancer Cardiac Cataract Hip Knee MRI CT %ALC CCAC CMG MH SA
Erie St Clair 24.78 6.93 3.97 97% NA 95% 85% 77% 21% 96% 23.22% 16 16.60% 16.69% 23.34%
South West 25.30 6.23 3.55 92% 100% 88% 82% 83% 27% 72% 8.58% 20 18.19% 18.88% 19.19%
Waterloo Wellington 15.88 6.30 4.25 99% 100% 96% 89% 85% 31% 69% 13.56% 11 16.94% 14.39% 25.81%
Hamilton Niagara
34.00 7.15 4.57 89% 100% 84% 84% 77% 44% 78% 17.40% 22 16.35% 20.15% 25.52%
Haldimand Brant
Central West 32.30 7.22 3.50 94% NA 89% 50% 37% 14% 86% 6.11% 23 14.80% 24.20% 28.95%
Mississauga Halton 39.20 6.32 3.58 98% 98% 94% 98% 77% 18% 52% 9.90% 23 15.69% 17.28% 25.95%
Toronto Central 27.62 7.75 4.47 95% 99% 92% 90% 94% 39% 59% 8.14% 25 19.02% 27.13% 44.76%
Central 33.70 6.52 3.42 100% 98% 100% 96% 92% 35% 89% 13.65% 27 15.12% 19.63% 23.11%
Central East 33.13 6.10 3.97 97% NA 97% 97% 96% 47% 92% 13.95% 21 17.29% 19.19% 27.34%
South East 26.22 6.67 4.23 99% 100% 94% 68% 72% 38% 96% 15.44% 28 15.41% 21.62% 26.46%
Champlain 25.15 7.45 4.48 97% 75% 90% 90% 88% 31% 76% 12.33% 55 15.57% 18.18% 27.48%
North Simcoe Muskoka 25.18 6.10 3.85 100% NA 98% 92% 84% 10% 60% 17.05% 54 16.74% 16.16% 25.17%
North East 30.87 5.40 3.85 84% 100% 90% 79% 73% 43% 69% 20.35% 64 19.16% 17.62% 34.18%
North West 30.52 6.97 3.87 93% NA 95% 73% 69% 33% 89% 22.54% 32 17.03% 17.29% 33.91%
Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q3 14/15 Q2 14/15 Q2 14/15 Q1 14/15 Q2 14/15 Q2 14/15
14.00 6.00 4.00 5.00 3.00 6.00 1.00 8.00 12.00 14.00 4.00 5.00 4.00 4.00 6.00
Re-
Measures Hours % within Access Target %ALC Days Admits Repeat Visits
Provincial 29.52 6.78 4.00 95% 97% 93% 88% 83% 33% 79% 13.32% 28 16.86% 19.95% 31.71%
Maximum 39.20 7.75 4.57 100% 100% 100% 98% 96% 47% 96% 23.22% 64 19.16% 27.13% 44.76%
Minimum 15.88 5.40 3.42 84% 75% 84% 50% 37% 10% 52% 6.11% 11 14.80% 14.39% 19.19%
Variance 23.32 2.35 1.15 16% 25% 16% 48% 58% 37% 45% 17.11% 53 4.36% 12.75% 25.57%

Color coding reflects LHIN relative performance from better 1

to 2
worse 3

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Board Quality Board Quality Report (Balanced Scorecard)

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NOTABLE SECTOR ENGAGEMENT

Multi-Sector Sector Accountability Agreement (M-SAA) Activity Target Date
2015/16 Schedule Refresh CAPS 60 Day Issuance Notice to HSP’s Oct. 17, 2014

The 2015-16 CAPS and M-SAA Refresh Update Pan LHIN Community Lead Education Oct. 31, 2014

The completed Health Service Providers, Board approved CAPS CAPS Launch onto SRI for HSPs Nov. 4, 2014

refresh, have been submitted for LHIN review. Approximately 25 HSP Training Materials Available Nov. 4, 2014
Health Service Providers required funding adjustments. However, all LHINs Complete Local HSP Q&A Session Nov. 13, 2014
of the Mississauga Halton LHIN Health Service Providers were Completed HSP Board approved CAPS refresh submitted Nov. 4, 2014 –
required to open and close the new CAPS template in order for them through SRI to LHINs by January 9, 2015 Jan. 9, 2015 (9
WEEKS)
to be able to utilize the new template going forward.
LHIN review of CAPS refresh, consultations on MSAA refresh Jan. 9– Feb16,
indicators, population of Schedules, and final MSAA Schedule 2015 (5 WEEKS)
We have received the amended 2015/16 M-SAA with the updated amendments
schedules from the MSAA Planning & Schedules Work Group and 2015/16 MSAA Schedule amendment letters provided to HSPs Feb 16, 2015
the MSAA Advisory Committee for implementation into the refresh HSP Board Approval of 2015/16 MSAA Schedule amendments March 9, 2015
process. There is one (1) new indicator related to Governance LHIN Board Approval of 2015/16 MSAA Schedule amendments March 9 – April 1,
specified within Schedule E3, Mississauga Halton LHIN Specific 2015

Performance Obligations. Year 2 of the current 2014-17 MSAA comes into effect April 1, 2015

Below are the key steps and estimated timelines for the 2015-16 M-
SAA refresh for completing the 2015/16 CAPS & MSAA Schedule
refresh.

Green indicates completed activities, yellow indicates in progress and

blue is yet to be completed.

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MOHLTC Updates
Priorities
Hospital Sector Accountability Agreement (H-SAA)
2014/15
The Mississauga Halton LHIN has fully executed the Hospital Service
Accountability Agreements (H-SAA) with Trillium Health Partners
and Halton Healthcare Services. The Mississauga Halton LHIN
continues to work with hospitals on determining performance, volume
and financial targets for 2014/15. With funding letters received late
December 2014, the Mississauga Halton LHIN will set performance
targets and expectations in collaboration with hospital partners.
2015/16
A new approach for the H-SAA will unfold for fiscal 2015/16
whereby the hospital annual planning submission submitted to the
LHIN in the winter 2015 with the goal of having fully executed
agreements by March 31, 2015. The LHIN has already communicated
its intent to enter into a new H-SAA for the 2015/16 fiscal year.
A new, multi-year 2015-18 H-SAA has been circulated to the Ontario
Hospital Association for their memberships’ review and feedback.
With the prospective endorsement of this agreement, the LHINs and
hospitals will work through an approach to refresh performance
targets, funding and volume annually. In the interim, an extension
agreement will be forthcoming for the beginning of the 2015/16 fiscal
year with a maximum term of six (6) months.
Community Quarterly Sector Meeting
The next Community Quarterly Sector Meeting is on April 10, 2015.
February 2015
Measurement and Notable Sector
Communications
Performance Engagement
Mississauga Halton Community Care Access Centre
The Mississauga Halton Community Care Access Centre (CCAC)
received Mississauga Halton LHIN approval in late January to further
support hospital surge by increasing additional resources to enable the
avoidance of admission to the hospital and/or safe discharge of
patients to the community.
The LHIN also endorsed the CCAC to declare a priority status in
support of a regional hospital flow crisis related to hospital patients
waiting for long-term care beds between December 15, 2014 and
January 12, 2015. The priority status, as described in the Long-Term
Care Home Act, Regulation 171, Section 3, shifts priority of
placement to those patients waiting in hospital versus those waiting in
the community. The regional efforts of all partners enabled 44 people
to be placed in long-term care compared with an average of 20
without priority status in place.
Quality Improvement Workshops
The Mississauga Halton LHIN in conjunction with the Central West
LHIN has collaborated with the Metamorphosis Community Health
Network to support two half-day workshops on quality improvement
for board members and senior leaders of community based HSPs.
These workshops are based on similar workshops offered to
community support service HSPs in September 2014 as part of the
Ontario Community Support Association’s (OCSA) Quality
Advantage Project.
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Quality Improvement Workshops – cont’d

The targeted HSPs were Mississauga Halton LHIN community mental
health and addictions HSPs who were not eligible to participate in
September’s workshops and those community support HSPs who
were unable to attend. The workshops were held on February 3 and
18 and covered topics such as leadership for quality and quality
improvement plans.

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 Annual Business Plan Measurement and
MOHLTC Updates
Priorities Performance
COMMUNICATIONS
Media Relations
Engaging with our media partners includes the development and
distribution of news stories through either Mississauga Halton LHIN
news releases or repurposing information shared by our health service
providers or the Ministry of Health. Several news releases and media
stories referenced Mississauga Halton LHIN from January to March
2015.
News Releases
Health Link Releases:
• Halton Hills – MPP Naidoo-Harris Ontario Improving Care for
Patients with Greatest Needs in the Mississauga Halton LHIN
• South Etobicoke - MPP Peter Milczyn
• South West Mississauga – MPP Charles Sousa.
News Coverage – Mississauga Halton LHIN
 New Health Link to benefit patients in southwest Mississauga –
Mississauga News – February 13, 2015
 Halton equitable drug strategy gets $149k OTF grant to help build
‘made-in Halton drug strategy’ - Oakville Beaver – February 8,
2015
 Improving Care for Patients with Greatest Needs – chrgonline.com
- February 5, 2015
February 2015
Notable Sector
Communications
Engagement
 Linking care to the community - Milton Canadian Champion –
January 30, 2015
 Oakville Mayor Rob Burton to chair Halton police board — again
– Oakville Beaver – January 30, 2015
 Linking care to the community - Georgetown Independent Free
Press – January 30, 2015
 Lifetsyle changes can reduce cancer risk: Mississauga
Halton/Central West Regional Cancer Program – Oakville Beaver
– January 1, 2015.
Engagement
Website
The Mississauga Halton LHIN website continues to be a primary
vehicle for both communication and engagement with our
stakeholders. Translation of website content is now fifty per cent
complete and on target to go live in early March 2015.
Visual Identity
We are introducing an important update to the LHIN Visual Identity.
The new pan-LHIN visual identity has been completed and approved.
The improvements include an expanded use of imagery to include
various types of illustrations, social media guidelines,
recommendations to emphasize each LHIN’s local and regional
character and AODA compliant templates.
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One of the most notable changes is the replacement of the former Local Government Leaders
wave graphic with the arc graphic, a government wide design motif. Bill MacLeod and Graeme Goebelle continue to meet with local
government leaders to discuss the Mississauga Halton LHIN priorities
Communications has launched the new visual identity internally and any emerging local healthcare issues. During the month of
providing staff with various templates and guidelines for use. January, meetings were held with Halton MPP Naidoo-Harris and our
Mississauga Halton LHIN materials requiring updating have been new Etobicoke--Lakeshore MPP Peter Milczyn.
identified and are in the process of renewal.
Press Conferences
Patient Experience Survey
The new Patient Experience Survey was Health Link Announcements - Mississauga Halton LHIN hosted
launch on January 31 and supports the media events to announce three new Health Links.
ongoing commitment of the LHINs to use
patients/families/caregivers and Halton Hills Health Link
community engagement to inform Standing inside Georgetown District Hospital, Halton MPP Indira
decision-making. The survey was developed by patients and families, Naidoo-Harris announced a new initiative, Halton Hills Health Link.
for patients and families. The survey is accessible through
Mississauga Halton LHIN website through the top rotating banner and MPP was joined by Halton Hills Mayor Rick Bonnette Denise
a box on the home page. To help build awareness, a poster was Hardenne (HHS President and CEO), Graeme Goebelle (LHIN Board
created and shared with local health service providers. This Patient Chair), Kiran Cherla (Halton Hills FHT), and Kate Power (CEO,
Experience Survey is a way to measure: Links2Care).
• How easy it is for patients to access the care they need and
navigate their local health system
• The overall quality of care patients receive
• How satisfied patients are with the care they receive
• Ways we can improve our health care system.
The survey closes on February 26. The feedback will help us to
identify priorities, allocate resources and plan for appropriate services
to improve the health care system for everyone.

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South Etobicoke Health Link South West Mississauga Health Link

LAMP CHC hosted Etobicoke-Lakeshore MPP Peter Milczyn as he Mississauga Halton LHIN vice-chair Ron Haines welcomed
announced two new initiatives that will impact South Etobicoke’s Mississauga South MPP Charles Sousa who announced the South
most complex patients. West Mississauga Health Link lead by Mississauga Halton CCAC

(Left to Right) Dr. Michael Kates (Summerville Family Health Team), Bill
(Left to Right) Angie Burden, Mississauga Halton CCAC, Ron Haines, Vice
MacLeod (Mississauga Halton LHIN CEO), Ruth Mary James (Patient
Chair Mississauga Halton LHIN, Karen Ras, Ward 2 Councillor, MPP
Representative), MPP Peter Micyzn, and Russ Ford (LAMP Community
Charles Sousa – Mississauga South, Caroline Brereton, CEO, Mississauga
Health Centre Executive Director).
Halton CCAC, Bill MacLeod, CEO, Mississauga Halton LHIN.

Health Links
• Health Links have expanded to 67 in
communities across Ontario.
• A study found that 75 per cent of seniors with
complex conditions who are discharged from the
hospital receive care from six or more doctors.
• There are seven Health Links in Mississauga
Halton LHIN

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Government and Community Services Fair The Government and Community Services Fair was co-hosted by
The Mississauga Halton LHIN participated in the 10th Annual MPP Etobicoke Centre Ivan Baker and Etobicoke--Lakeshore MPP
Government and Community Services Fair at Cloverdale Mall on Peter Milczyn.
February 21, 2015. Handing out clementines and sharing information,
the Mississauga Halton LHIN spoke with local residents about Reports
partnering with our communities for a healthier tomorrow.
Community Capacity Study
We joined more than 100 exhibitors who filled the community in on The Community Capacity Study conducted by Preyra Solutions
the bounty of local activities, business networks, specialty shopping, Group, Meeting Senior Care Needs Now and in the Future: A
volunteer opportunities and government initiatives that take place all Community Capacity Plan for the
the time in our local community. Mississauga Halton LHIN, was
submitted to the Community Capacity
Study Steering Committee on February
13, 2015.

Mississauga Halton LHIN is preparing

communications strategy to identify,
engage and inform a variety of internal
and external stakeholders.

Mississauga Halton LHIN has prepared

an executive summary document which
includes highlights and key
recommendations from the report.

Left to Right: Tom Miller, Central West LHIN, Christelle Bony,

Mississauga Halton LHIN, MPP Yvan Baker, Maureen Buchanan,
Mississauga Halton LHIN, Andrea Skacolzai, Central LHIN, Monica Scott,
Toronto Central LHIN

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 Attachment A

Mental Health and Addictions Strategy:

Phases 1 and 2 Overview

Slide Deck #1
Mental Health and Addictions Leadership Advisory Council Meeting
February 6, 2015
Table of Contents:
Section 1: Overview of Mental Health & Addictions Landscape in Ontario
• Impact
• Cross-sectoral involvement
• Complex system delivery and funding
• Challenges

Section 2: Ontario’s Mental Health & Addictions Strategy

• Strategy overview
• Phase 1 overview
• Phase 2 overview
• Initial implementation priorities
• Mental Health and Addictions Leadership Advisory Council
• Aboriginal engagement
• Performance measurement
• Initiatives

2

Mental health and addictions issues impact Ontarians:
Overall prevalence:
30% of the Ontario population aged 15+ will
experience a mental health or substance
abuse problem at some point during their life.
Prevalence of mental health issues:
• Almost 5% of Ontario adults reported
experiencing symptoms of major
depression in 2012 (StatsCan), and 2.2%
reported suicidal ideation in the last 12
months (CAMH).
• Mental health conditions are often co-
occurring. For example, almost 50% of
Ontarians with schizophrenia also report
a substance abuse problem.
Prevalence of substance abuse &
addictions:
• 18.8% of adults reported exceeding low-
risk alcohol guidelines in the past year.
6.8% of adults and 19.8% of students
report binge drinking.
• 2.8% of adults and 12.4% of high school
students reported using prescription
opioids for non-medical use in 2013.
• 4.7% of Ontarians report having a
gambling problem.
Cost to the province:
Mental illness and addictions
cost Ontario’s economy an
estimated $38.1B a year.
These costs include:
• health care costs.
• law enforcement costs.
• research and prevention
• other direct costs (e.g. fire,
accidents).
• indirect costs (lost
productivity due to disability
and premature mortality).
Socials costs to Ontarians:
• Alcohol-related crash
fatalities: 255 deaths in 2009
(MADD).
• Suicides: 8.1 per 100,000
(2011 StatsCan).
• Burden of disease on young
adults: Alcohol and drug
addictions are most prevalent
in the 25-34 age bracket.
MH&A Landscape
Examples of
Populations at Risk:
Many populations are at higher
risk of either developing a
mental health issue, or of being
marginalized from participating
in mental health services. For
example:
• First Nations population: First
Nations youth commit suicide
about five to six times more
often than non-Aboriginal
youth (Health Canada).
• Individuals with dual
diagnosis: Roughly 44 % of
the 18-64 year old cohort of
Ontarians who have a
developmental disability also
have a mental illness
(HCAARD).
• Children and youth: Mental
health problems among
children and youth are
predicted to increase by 50
per cent by the year 2020.
3
 MH&A Landscape
MH&A are complex, and cut across many different
sectors and levels of government:
Implications:

Confusion/frustration for clients:

Health • System navigation is complicated by
the number of players in the MH&A
Social sector.
Education
Services
Resources not maximized:
• Lack of coordination and alignment
across and between
sectors/providers.
Justice Housing
• Competing priorities across the
MH&A
sector.
Clients
Hard to make the case for results and
investments:
Municipal Jobs and • Overlap in clients served makes it
Gov’t Training difficult to approximate total
government spend or cost per
MH&A client.
Federal Children • Different data systems are in use
Gov’t and Youth
and/or key gaps exist in the data (e.g.
wait times, demand).

4
 MH&A Landscape
Delivery system, accountability/governance mechanisms, and funding
structures are very complex (see MOHLTC example below):

MOHLTC:
Provincial
$47.4M $3.1B 2013-14 expenditure on
Supports OMA Ontario Drug Benefit
mental health and addictions Negotiations Programs Exec Officer

MLPA
$656.4M $500.9M
$1.9B

LHINs OHIP Drugs

H-SAA
M-SAA
$913.7M
$994.4M

Hospitals
Mental
MH&A Community Supports: Physicians and
Specialty
Health
Psych 300+ Service Providers Specialists
Units

Service Collaboratives Health Links MCYS Lead Agencies

Ontarians with MH&A issues

Refer to Landscape Report for more detail
Legend:
Purple: Delivery system
Grey: Accountability/governance
Green: Funding 5
 MH&A Landscape

Despite best efforts by all parties, significant challenges remain:

Limited focus on
prevention and early
intervention:
Limited focus on public
health and health
promotion
Self-help options not
maximized
Employment supports
Limited training for
providers about early
identification
Unmet need: Gaps in services: Funding issues:
Access to services Funding based on
Uncoordinated care
historical allocations
Supportive housing
No standardization of
Many parties involved funding across
providers
Poor transitions Funding not tied to
Justice transition and
through care outcomes
diversion

Weak data collection and performance measurement

Inconsistent data Limited performance Minimal service cost Minimal provincial
collection reporting data public reporting

6
 Strategy Overview
Ontario’s Mental Health and Addictions Strategy:

• Launched in 2011, Open Minds, Healthy Minds is Ontario’s comprehensive

mental health and addictions strategy, which aims to address these systemic
issues.

• Strategy vision statement: Every Ontarian enjoys good mental health and
well-being throughout their lifetime, and all Ontarians with mental illness or
addictions can recover and participate in welcoming, supportive
communities.

• The Strategy is divided into two phases:

Phase 1: Launched 2011
• Led by MCYS.
• Focused on children and youth mental health.
• Ongoing transformation in children and youth mental health system will be be aligned
with Phase 2.

Phase 2: Launched 2014

• Led by MOHLTC.
• Expanded scope and scale of Phase 1 to focus on adults,
transitional aged youth, addictions, transitions, funding
reform, and performance measurement across the
system.

7
 Strategy: Phase 1
Phase 1 made significant progress:

8
 Strategy: Phase 1
Phase 1 key initiative: Moving on Mental Health

• Building on the foundational work in the first three years of Open Minds, Healthy Minds,
the Moving on Mental Health (MOMH) plan was launched in 2012.
• The plan will result in a simplified and improved experience for children and youth with
mental health problems and their families so that, regardless of where they live in Ontario,
they will know:
• What mental health services are available in their communities; and
• How to access the mental health services and supports that meet their needs.

• To achieve the goals of MOMH, MCYS is leading and coordinating efforts to:
• Create and support clear pathways to care;
• Define core services;
• Establish lead agencies in every Ontario community that will be responsible for the
planning and delivery of services;
• Develop a transparent, equitable funding model; and
• Put in place appropriate legislative, regulatory, and accountability tools.

• In August 2014, MCYS announced the first 14 lead agencies for child and youth mental
health.

9
 Strategy: Phase 1
Phase 1 key initiative: Moving on Mental Health (cont’d)

• Identified agencies will take a leadership role in convening and coordinating partnerships
within the child and youth mental health service sector as well as across other sectors such as
health and education in order to provide clarity for children, youth, and their families about
how to access mental health services within those service areas.

• As a first step, lead agencies will be developing an initial core services delivery plan with other
child and youth mental health service providers and working towards the development of an
initial community mental health plan with the broader child-serving sector.

• There will be a phasing-in of lead agency responsibilities over the next two to three years, in
recognition of the fact that lead agency role and functions are new and that capacity to carry
them out will vary across the province. MCYS will be providing a range of supports to lead
agencies to assist them in building the necessary capacity.

• The identification process for a lead agency in Toronto was launched on September 12, 2014.

• The remaining lead agencies are expected to be announced in 2015.

10
 Strategy: Phase 2
Phase 2 is guided by key outcomes to be achieved, and
work across five strategic pillars:
Open Minds, Health Minds Vision:
Every Ontarian enjoys good mental health and well-being throughout their lifetime, and all Ontarians with mental
illness or addictions can recover and participate in welcoming, supportive communities

By 2020, the strategy will support the following outcomes:

• Better service experiences
for people and their families
• Improved access to services
• More people stably housed
• Fewer avoidable hospital
admissions or readmissions
• More people identified and • Improved transitions of • Reduced absenteeism at work
served through integrated youth to adult system • More people feel safe,
primary care and community • More people receiving engaged and supported at
services evidence-based programs work
• Reduced reliance on • More students graduating
emergency departments high school

Phase 2: Strategic Pillars

Pillar 1: Pillar 2: Pillar 3: Pillar 4: Pillar 5:

Expand housing,
Promote Ensure early employment Right service, Fund based
resiliency & identification supports & right time, on need and
well-being in and diversion and right place quality
Ontarians intervention transitions from
the justice
system

Integrated system planning and system accountability:

Establish and strengthen the critical functions of provincial quality, oversight and accountability
of mental health and addictions services
11
 Strategy: Phase 2

There are three initial implementation priorities for Phase 2:

Enhance oversight and accountability: Establish Mental Health and Addictions

1. Leadership Advisory Council to advise the Minister and to report on Phase 2 progress,
and establish a dedicated Aboriginal engagement process.

Improved performance measurement: Work with Health Quality Ontario (HQO) and
2. the Institute for Clinical Evaluative Sciences (ICES) developing a scorecard and
evaluation framework to measure progress and outcomes.

New initiatives and funding investments: $138 million over three years through the
3. 2014 Budget to community service agencies to help increase access to services such as
peer support groups, treatment programs, and crisis and early intervention initiatives.

12
 Strategy: Phase 2

The MH&A Leadership Advisory Council has been established:

• In November 2014, the Minister of Health and Long-Term Care announced the creation of the Mental
Health and Addictions Leadership Advisory Council.

• The members of the new Mental Health and Addictions Leadership Advisory Council represent diverse
sectors that work on mental health and addictions issues. A membership list can be found in Appendix 1.

• The Council will meet 3 times per year, and will be supported by a Secretariat from the Ministry. The
Council will also establish working groups as required.

• The Council has the following key deliverables:

• System-level priority setting, problem identification and work

1. Strategic Planning planning.

2. Advice on Strategic Provincial • Advice on allocation of government investments in mental health

Investments and addictions.

• External oversight and accountability of key strategic initiatives;

3. Implementation of the Strategy cross-sector champions.

4. Tracking Progress and Public • Author annual progress report (w/ ICES and HQO).
Reporting
• Provide meaningful advice to the government on MH&A
5. Ad hoc Advice on MH&A Initiatives issues/initiatives.

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 Strategy: Phase 2
An Aboriginal engagement process is being established
• The MHA&A Aboriginal engagement process will building on the success of recent engagements by MCYS.
• Separate funding will be provided directly to First Nation, Métis and urban Aboriginal Provincial Territorial
Organizations (PTOs) (and associated governance / discussion tables) who will then conduct / coordinate
engagements of their own design with their respective membership and report back with results.
• Details of linkages between the Council and this engagement process are still to be determined.

Advice to Minister of Advice to MH&A

Health and Long-Term Leadership Advisory
Care Council

Details are TBD in terms of content, format and timing of advice to

government

Urban Aboriginal
Chiefs Committee on Keewatin (Northern)
funding Health Table
Health / TFNHSOC* Table Trilateral Health Table
(in development)

Social, Health and Education (SHE) Directors Committee

Assoc. of Ont. Fed. of Ontario

Indepen- Union of Grand Métis
Chiefs of Iroquois & Nishnawbe Indigenous Native
funding dent First Ontario Council Nation of
Ontario Allied Aski Nation Friendship Women’s
Nations Indians Treaty #3 Ontario
Indians Centres Association

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*TFNHSOC is Trilateral First Nations Health Senior Officials Committee
 Strategy: Phase 2

Performance Measurement for Phase 2:

Draft Logic Model for Performance Measurement
• A strategy scorecard and evaluation
Strategy Vision
framework is being developed to
measure progress and outcomes in
against each of the pillars of Phase 2.
Pillar 1: Pillar 2: Pillar 3: Pillar 4: Pillar 5:
 Building on the scorecard and
framework developed for Desired Desired Desired Desired Desired
system system system system system
Phase 1. change change change change change
 In collaboration with ICES,
HQO, partner ministries,
Council.
Performance/outcome measures where possible, contextual
indicators and process/output measures as proxies if
• To support this work, MOHLTC is also required
leading a cross-ministry data integration
project on broad social determinants.

• A Quarterly Initiative Tracking process Aligned initiatives

has also been established to track
different MH&A initiatives that are
underway in each ministry against each
of the pillars.

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 Strategy: Phase 2

Several key new MOHLTC initiatives are already underway:

• Investments of $138M over three years to be invested in proven local mental health and addiction initiatives
that align with the Strategy’s five strategic pillars.

• $2.75M to improve access to mental health care and reduce wait times at four speciality psychiatric hospitals:
• Centre for Addiction and Mental Health (Toronto)
• Waypoint Centre for Mental Health (Penetanguishene)
• The Royal (Ottawa)
• Ontario Shores Centre for Mental Health Services (Whitby)

• $16M to create 1,000 more supportive housing spaces over the next three years, as part of the Poverty
Reduction Strategy.

• Improving supports for youth with eating disorders through a pilot program with Ontario Shores, which has
opened a new 12-bed paediatric residential treatment unit treating 32 patients per year.

• Creation of a province-wide inpatient bed registry that will allow hospitals to access information about the
availability of inpatient psychiatric beds in Schedule 1 facilities across Ontario.

• Partnering with the province's public health units to increase awareness, address stigma and promote mental
health in schools and in the workplace.

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Appendices

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Appendix 1: MH&A Leadership Advisory Council Membership List

1. Susan Pigott - Chair of Ontario's Mental Health and Addictions Leadership Advisory Council; has previously
held senior positions with the Centre for Addiction and Mental Health and St. Christopher House
2. Pat Capponi - Psychiatric survivor with lived experience of poverty; part-time member, Consent and Capacity
Board
3. Gail Czukar - CEO, Addictions and Mental Health Ontario
4. Dr. Suzanne Filion - Director, Strategic Initiatives, Mental Health and Addictions, Hawkesbury & District General
Hospital
5. Arthur Gallant - Mental health advocate
6. Carol Hopkins- Executive Director, National Native Addictions Partnership Foundation;
7. Mae Katt - Nurse Practitioner
8. Dr. Kwame McKenzie - CEO, Wellesley Institute
9. Dr. Ian Manion - CEO, Provincial Centre for Excellence for Child and Youth Mental Health, Children's Hospital of
Eastern Ontario
10. Louise Paquette - CEO, North East Local Health Integration Network (LHIN)
11. Camille Quenneville - CEO, Canadian Mental Health Association - Ontario
12. Dr. William Reichman - President and CEO, Baycrest
13. Aseefa Sarang - Executive Director, Across Boundaries: An Ethnoracial Mental Health Centre
14. Dr. Kathy Short - Mental Health ASSIST lead, Hamilton-Wentworth Board of Education
15. Peter Sloly - Deputy Chief, Community Safety Command, Toronto Police Services
16. Adelina Urbanski - Commissioner, Community and Health Services, Regional Municipality of York
17. Victor Willis - Executive Director, Parkdale Activity and Recreation Centre
18. Eric Windeler - Founder and Executive Director, Jack.org
19. Dr. Catherine Zahn, CEO, Centre for Addiction and Mental Health

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