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Central East CCAC Board Agenda

Date: Wednesday, February 10, 2016 Place: Central East CCAC, Whitby Branch, Durham Room

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

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1. Introductory Items

1.1. Call to Order L. Lifchus

1.2. Confirmation of Quorum L. Lifchus

1.3. Approval of Meeting Agenda X X L. Lifchus

1.4. Declaration of Conflict L. Lifchus

2. Board Education/ Generative Discussion Vl-1

2.1. Patients First – Update & On-going transition

discussion

X X

3. Minutes of Previous Meeting, Action Items and

Business Arising

3.1. January 13, 2016 Board Meeting Minutes, In-

Camera Minutes and Action Items

X X L. Lifchus

3.2. Durham Governance Advisory Council

X D. Ford

4. Reports

4.1. CEO Report to the Board X X D. Ford

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

4.3. Finance Committee (draft Minutes) X Part IV X P. Connolly

4.4. Audit Committee (draft Minutes) X Part IV X R. Morphew

4.5. Governance Committee (draft Minutes) X Part V X G. Lounsbury

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

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

may email a request to the meeting coordinator.

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

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4.7. OACCAC Report

Vl-4 X D. Ford

5. New Business

6. Correspondence

9. Adjournment X L. Lifchus

Central East CCAC Board Meeting – January 14, 2016 Page 1 of 5

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE BOARD MEETING

MINUTES

Date: January 13, 2016

Time: 6:30 pm

Present: Len Lifchus (Chair), Gary Lounsbury (Vice-Chair), Don Ford

(CEO), Glenn Rogers, Susan Donaldson, Rick Morphew, Carmen Nisbet, Michelle Rawnsley, Derrick McLennon, Andy Williams and

Sylvia Patterson Teleconference: Nicola Crow

Regrets: Patrick Connolly

Guests: Kathy Ramsay, Lisa Burden and David Stringer

Recorder: Robin Russell

1.0 In Camera The Board Chair called the meeting to order at 6:30pm and declared the

meeting would move immediately in to the In Camera portion of the meeting. (PER POLICY V-B-7 FOR MATTERS RELATED TO PERSONNEL)

MOTION: TO MOVE OUT OF IN CAMERA AT 6:53 PM

MOVED: Susan Donaldson SECOND: Glenn Rogers CARRIED

MOVE OUT OF IN CAMERA

2.0 Report of Actions taken In-Camera

Board Members moved to offer the position of Chief Executive Officer of the Central East CCAC to K. Ramsay for a two year term and shall be extended for a further two, one year, terms.


3.0 Introductory Items

3.1 Call to Order

The Chair requested the G. Lounsbury act as Chair, excusing himself from the meeting. G. Lounsbury called the regular meeting to order at

6:55p.m.

Len Lifchus left the meeting.

3.2 Quorum

A quorum was present

3.3 Approval of Meeting Agenda

MOTION: TO APPROVE THE AGENDA OF JANUARY 13, 2016,

AS AMENDED, TO RECOGNIZE THAT THE BOARD

CHAIR CALLED FOR THE IN CAMERA SESSION TO BEGIN THE MEETING

MOVED: Derrick McLennon SECOND: Susan Donaldson CARRIED

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

G. Lounsbury asked for a declaration of conflict. None were declared.

Len Lifchus returned to the meeting with Kathryn Ramsay, resumed the Chair

position, and introduced Kathryn Ramsay as the new CEO of the CECCAC as of April 1, 2016.

4.0 Board Education / Generative Discussion

4.1 Patients First: A Proposal to Strengthen Patient-Centred Health

Care in Ontario – Discussion Paper

D. Ford facilitated a discussion with Board Members on the Ministry of

Health and Long Term Care discussion paper, Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario, with a focus on

how the proposal relates to the Community Care Access Centres and the suggested health care sector transformation.


5.0 Minutes of Previous Meeting, Action Items and Business Arising

5.1 December 9, 2015 Board Meeting Minutes and Action Items

The Minutes and Action items for the December 9, 2015 Board Meeting were reviewed with no changes noted.

MOTION: TO APPROVE THE DECEMBER 9, 2015 BOARD

MEETING MINUTES AND ACTION ITEMS

MOVED: Sylvia Patterson SECOND: Derrick McLennon CARRIED

ACTION: R. Russell to provide Board Members with the dates of the

2016 OACCAC Conference and compile a list of Members interested in attending.

6.0 Reports

6.1 CEO Report to the Board D. Ford spoke to the January 2016 CEO Report to the Board, as

circulated. D. Ford highlighted the Long Term Care Home introductory videos.

L. Burden spoke to the Community Support Service (CSS) - Personal

Support Service (PSS) transition, a program to expand the role for

CSS as part of the new MOHLTC agenda to maximize community resources. L. Burden advised that the CECCAC is part of the pilot

program with 8-10 patients whose services have been transferred over to CSS to date.

6.2 PQE Committee

No meeting to report

6.3 Finance Committee

D. Stringer spoke to the Finance Committee Minutes as circulated and

spoke to the upcoming renewal of Branch leases. The Peterborough Lease will be renewed for two years; the Haliburton lease, set to expire

in July, 2016, will be extended for two years, but with a significantly smaller footprint. D. Stringer also advised that the budget recovery plan is currently on track, anticipating a balance position at March 31,

2016.


D. Ford spoke to the CECCAC waitlist and advised that the Central East LHIN had been approached by MOHLTC about waitlist management. It

is understood that the Ministry is currently reviewing the CECCAC waitlist and funding requirements.

6.4 Audit Committee

R. Morphew advised that the Audit Committee will be meeting with auditors on Jan 18, 2016, to begin the audit process for 2015/16.

6.5 Governance Committee G. Lounsbury spoke to the Governance Committee meeting of January

13, 2016.

The CECCAC Board Terms were reviewed and G. Lounsbury advised that four Board Member terms are set to end, two members having the option to renew and two at the end of their terms. G. Lounsbury

acknowledges that the CECCAC Board will likely proceed with 10 Board Members and the vacant positions will not be filled, given the

upcoming transition. The CECCAC Board and Committee evaluation forms were reviewed

and the Committee decided to proceed with the evaluations, as scheduled. The Governance Committee also confirmed that the annual

Board Retreat is in abeyance. G. Lounsbury advised that there may be a Board Retreat or Special Board meetings required to discuss the transition.

6.6 Report of the Chair

L. Lifchus advised that the CCAC Board Chairs have been meeting frequently to discuss the proposed changes and advised that a lawyer

had been retained by the OACCAC to provide legal opinion related to the upcoming transition. The lawyer is available for discussion with

individual CCAC Boards, if needed, at the expense of the CCAC.

6.7 OACCAC Report

No meeting to report

MOTION: TO ACCEPT REPORTS FOR ITEMS 4.1- 4.7 AS INFORMATION.

MOVED: Derrick McLennon SECOND: Susan Donaldson CARRIED


7.0 New Business

7.1 Durham Governance Advisory Committee

D. Ford advised that the CECCAC does not currently have a representative for the Durham Governance Advisory Committee.

Sylvia Patterson volunteered to represent the CECCAC Board. ACTION: R. Russell to provide required documentation need to

complete the application for the Durham Governance Advisory Committee to S. Patterson.

7.2 CAPS Document

D. Stringer spoke to the CAPS document, as circulated. D. Stringer advised that the CECCAC, with this CAPS, is submitting a deficit

position document and advised the Central East LHIN that CECCAC is unable to responsibly meet the current needs of our existing patients within a zero based budget environment.

In February, 2016, the Finance Committee will review the impact of

our budget strategies on the 2016/17 spend.

MOTION: THE CECCAC BOARD APPROVES THE SUBMISSION

OF THE CAPS DOCUMENT TO THE CENTRAL EAST LHIN SHOWING A DEFICIT POSITION

MOVED: Andy Williams SECOND: Glenn Rogers UNANIMOUSLY CARRIED

8.0 Correspondence No new correspondence

D. Ford reminded Board members to submit expense reports

9.0 Adjournment of meeting

MOTION: TO ADJOURN MEETING AT 8:07 P.M.

MOVED: Susan Donaldson CARRIED

L. Lifchus, Chair Date

ACTION ITEMS FROM JANUARY 14, 2015 BOARD MEETING

Action Item Responsibility Time Line Status 1. Provide Board Members with the dates of

the 2016 OACCAC Conference and compile a list of Members interested in attending.

Robin Russell February 10, 2016 complete

2. Provide required documentation need to complete the application for the Durham Governance Advisory Committee to S. Patterson.

Robin Russell January, 2016 complete

February 2016 Page 1 of 11

The Central East CCAC CEO Report to the Board

February, 2016 Don Ford

Chief Executive Officer

Outstanding Care Partner

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

E-Referral to Assisted Living Services (ALS)

The Central East Community Care Access Centre (CECCAC), in collaboration with VON,

Carefirst, Yee Hong Centre for Geriatric Care, Haliburton Highlands Health Services,

Community Care Durham and Community Care City of Kawartha Lakes is pleased to

announce the launch of e-Referral for patient referrals to Assisted Living Services (ALS)

beginning on February 16, 2016.

Facilitated through the Health Partner Gateway (HPG), e-Referral to ALS will help to enhance

communication between the CECCAC and Central East Community Support Service (CSS) ALS

providers in a secure and timely manner. Providing email notification for new referrals, all

referral information will be sent at one time and for the information available in one place,

allowing users to locate and access all patient referral information from the Central East

CCAC.

Education for CCAC and CSS ALS provider staff is occurring during the first two weeks of

February, 2016.

Outstanding Care Partner Outstanding System Partner Outstanding Place to Work

Strategic Goals

Optimize Health Outcomes ☒ Balance Our Budget

☐ Develop Our People ☐

Provide Comprehensive System Navigation

☒ Collaborate with our

Community Partners Services

☒ Provide Healthy Safe

Workplaces

☐

Design Patient-Centric Programs

☐ Deliver High Value, Outcome-

based Care

☐ Support Flexible Work

Environments

☐

Promote Safe Independence ☐ Expand Partnerships

☐ Be an Innovative Learning Organization

☐ Ensure Quality and Safety

☐ Enable Service Excellence ☐


School Health Support Services Waitlist Strategy

In September 2014, a new Occupational Therapy (OT) model for the School Health Support

Services was introduced with recommended levels of service and guidelines to ensure

consistency of services delivered across the Central East.

With the development of the new model, one of the strategies identified was an education

session to the school boards which would assist school staff members in early identification

and intervention as well as to provide strategies that would support children with developing

fine motor skills. The intent of this strategy is the reduction in the volume of referrals that are

initiated from the school board.

In the fall of 2015, Senior Managers from the Children’s Team at the CECCAC met with the

Durham District School Board (DDSB). The following areas for education were identified as

important:

Fine motor: Students with fine motor delays associated with weak written communication

skills, poor classroom productivity and delays in the development of self-help skills;

Gross motor: Students with a disability which impacts functional abilities of mobilization,

transfers, cardiorespiratory status and/or demonstrating potential for improvement;

Lift and transfers: Ongoing equipment to maintain function;

Sensory: Poor body and spatial awareness, Poor cognitive attention, Delayed social skills,

Delayed social skills, Oral motor/feeding/diet concerns.

Based on the volume of referrals and the waitlist numbers, the decision was made to pilot the

education session at the DDSB. Focusing on the development of fine motor skills, the first

piloted education session occurred on January 22nd, 2016. Twenty-five (25) Educational

Assistants participated in this session. The comments and evaluations received were very

positive; the attendees identified the session as very helpful and recommended future

sessions.

Our next steps include a second piloted session on June 3rd, 2016 with the intention of

disseminating this education strategy to the remaining CECCAC District School Boards in the

next school year, 2016/2017.


Strategic Goals




☐ Collaborate with our



Workplaces

☐


☒ Deliver High Value, Outcome-

based Care


Environments

☐



☒ Ensure Quality and Safety

☒ Enable Service Excellence ☐


Stroke Research Study

The CECCAC has embarked on a partnership with the Aging, Community and Health Research

Unit at McMaster University to participate in a stroke research study, with the pilot funded by McMaster University. The study began planning stages in September, 2015 and will continue until March, 2017.

Under the McMaster Aging, Community and Health Research Unit, the goal of the research

study is to evaluate the feasibility, acceptability, effects and costs of a six-month inter-professional community navigation and rehabilitation intervention for stroke patients as compared to usual home care services for stroke survivors with multiple chronic conditions.

Working jointly with an inter-professional team, the community navigation and rehabilitation intervention aims to enhance health-related quality of life, promote community re-integration

into social and life roles, prevent subsequent strokes and reduce the onset or worsening of other chronic health conditions through the use of four “active ingredients”:

Strengths-based practice;

Holistic care (with a focus on prevention of recurrent strokes and management of multiple

chronic conditions);

Engagement and support (for both the stroke survivors and their family caregivers through

goal setting and care planning);

Collaborative practice (including the patient and family caregiver in shared decision-making

and linkages to other professional and community resources) .

Four Care Coordinators from the CECCAC will work collaboratively as part of a specially trained inter-professional team along with a nurse, therapists and a personal support worker.

Three CECCAC Senior Managers and a Contracts Assistant are responsible for the recruitment of patients. Two Service Provider Agencies were successful to an Expression of Interest,

which was issued to provide the full basket of services nursing, physiotherapy, occupational therapy, and personal support) to the patients.

Recruitment of the CECCAC patients began on January 18, 2016 and each patient group will participate for a six-month period. The complete study will take place over the span of one year, with the final paper and findings to be submitted by March 31, 2017.


Strategic Goals







Workplaces

☐



based Care

☒ Support Flexible Work

Environments

☐

Promote Safe Independence ☒ Expand Partnerships

☒ Be an Innovative Learning Organization

☒ Ensure Quality and Safety

☒ Enable Service Excellence ☒


Outstanding System Partner

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

embracing leading practices and innovation and achieving value for money.

Self-Directed Funding

The Ministry of Health and Long Term Care (MOHLTC) continues to work with representatives

from the Community Care Access Centres (CCAC), the Ontario Association of Community Care

Access Centres (OACCAC) and patient/families on a MOHLTC lead Technical Working Group to

draft the program specifications document for a Self-Directed Funding Program as part of the

Patients First Roadmap. The MOHLTC’s initial goal was to launch the Self-Directed Funding

Program pilot projects in 2015; however the Technical Working Group has required additional

time to work through the program specifications. A new launch date has not been confirmed

by the MOHLTC but it is anticipated that the launch will either be in the spring or fall of 2016.

The delay in the launch allows for further discussion and work to support the development of

Self-Directed Funding Program specifications that are fair and maintain an equitable balance

between those receiving eligible Self-Directed Funding Program services versus those that

continue to be directly serviced by the CCAC, a task that appears to be more challenging than

anticipated.

As the MOHLTC works through finalizing the Self-Directed Funding Program specifications, the

OACCAC and CCACs continue to provide the current self directed funding experiences and

service delivery knowledge from the sector, and more specifically from those CCACs currently

providing self-directed funding including the Central East CCAC, to the MOHLTC in support of

the development of the provincial program requirements. As well, the OACCAC and CCACs

have continued to work on the development of business process maps, information

booklets/resources and patient/family toolkits.

With the setbacks on finalizing the MOHLTC SDF Program Specifications, the Central East

CCAC Self-Directed Funding Project Team has delayed its work in establishing its processes

and materials to ensure that our program is consistent with the MOHLTC requirements.


Strategic Goals






☐ Provide Healthy Safe

Workplaces

☐



based Care


Environments

☐

Promote Safe Independence ☒ Expand Partnerships





Combined Palliative Care

On November 2, 2015 the Central East CCAC launched our new Combined Palliative Care

service delivery model with the goal of improving the patient and family experience. Our new

vison and steps to achieve our vison (outlined below) have been fully implemented. To date

682 patients have been admitted onto the program. Early reported benefits include increased

communication between the clinicians and the Care Coordinators resulting in improved

relationships, and with every likelihood, improved patient outcomes and experience although

this evidence has not been formally gathered to-date.

The project team continues to meet regularly however in the next few months the project

team will dissolve and will be replaced by an operational combined palliative care working

committee. This committee will be tasked with the ongoing review and evaluation of the new

care model to ensure that it continues to meet the needs of our patients.

Our vision is to incorporate improvement in three dimensions:

The patient/family perspective: it is a consistent team of skilled and compassionate

individuals helping me and my loved one access the services we need to support me in living the end of my life comfortable at home.

The service provider perspective: it is a positive experience delivered through locally-based specialized and designated care teams thoughtfully constructed to meet the unique needs of each patient and their family.

From the CCAC perspective: it is enhanced, coordinated access to high quality, specialized palliative care services 24/7 across the Central East LHIN geographic

boundary, delivered effectively and professionally to all in need of such services.

To achieve our vision Central East CCAC determined we need to:

Improve the patients experience specifically related to pain and symptom management and quality of life in the final months of life.

Change our service model; more specifically provide both nursing and personal support services from one agency within a geographic area. By bringing these two services

together in one agency, we will facilitate better communication and coordination within and across the interdisciplinary team, optimize nursing and personal support resources as well as improve management of delegated acts from nursing to personal support

workers. Enhance the skills, knowledge and abilities of the nurses and personal support workers

engaged in palliative care. Realign our geographic boundaries to ensure that services and service provider

agencies can effectively support and manage the fluctuations in service volume and

intensity.



Strategic Goals







Workplaces

☐



based Care


Environments

☐





Provincial Coordinated Care Tool (CCT) Proof of Concept

The Peterborough and Durham North East Health Links continue to participate in the

provincial Coordinated Care Tool (CCT) Proof of Concept project. Health Care organizations

supporting the two Health Links who have implemented the new electronic system are

actively uploading coordinated care plans into the new Coordinated Care Tool.

Central East Health Link partner organizations in the Peterborough Health Link are completing

coordinated care plans in the CCT for patients with complex care needs identified through the

Geriatric Assessment Intervention Network (GAIN) Intensive Case Management Team, the

Central East CCAC complex caseloads and through the Welcome Home Team at the

Peterborough Networked Family Health Team.

Initiation of new coordinated care plans for the Peterborough Health Link has actually declined

in numbers in Q3 despite rising over the last two quarters (see chart below). In order to

understand what may be contributing to this decline in numbers, the Steering Committee has

requested that the current organizations and users of the CCT continue to utilize the CCT

solution so that functionality and process issues can be reviewed by the Design Team through

a quality improvement approach and reasons for the lack of numbers can be more fully

explored. Once this is complete, a plan to proceed with existing organizations and users will

be implemented. Until this review is complete, the Peterborough Steering Committee has

advised the Design Team that onboarding of additional health service providers and internal

spread within organizations should be limited.


With Steering Committee direction, the Peterborough Design Team, which includes current

CCT using organizations, reviewed their experiences to date with the CCT in February 2016.

Overall, CCT users expressed that there are challenges and issues with the solution. Some of

these challenges were known before the pilot initiation but are yet to be rectified by the

vendor or the Ministry.

To date, the findings include:

The vendor has been notified concerning various functionality issues (e.g. IP

addresses being changed without notification, multiple log-in issues, and

functionality concerns not being addressed, separate log-on screens that are

time consuming, unable to pass a CCP from one lead provider to another

without closing and restarting the CCP). In December 2015, the vendor was

contacted and resolutions are being reviewed.

The training environment is not stable, there is a two part process that is

time consuming and not intuitive for new users. The vendor notified in

December 2015 and issues remain outstanding.

The CCT is unable to interface or be compatible with other solutions (e.g.

CCT to CHRIS) and is currently working as a standalone solution which is not

efficient since pre-population of patient data is not achieved. Vendor and

Ministry have been notified both at the start of the project and through

various reports and lessons learned documentation.

Health care organizations working within the Durham North East Health Link are also

completing coordinated care plans in the CCT for patients with complex care needs identified

in Lakeridge Health Oshawa (LHO) in-patient medical unit and Pinewood, and/or common

patients to LHO and the Central East CCAC serviced through the complex caseload. Durham

Mental Health Services, Canadian Mental Health Association Durham, Brock Community

Health Centre and Ontario Shores are also expected to onboard to the CCT in Q4 of the


2015/16 fiscal year. Nine new coordinated care plans have been entered into the solution

since go-live on November 17, 2015 for Q3, as indicated by the chart below.

Durham North East Health Link is taking a similar approach as Peterborough by evaluating the

CCT and has directed the Design Team to minimize further onboarding and internal spread so

that processes and the solution are better understood and aligned.

Overall, a report which provides the lessons learned regarding the implementation of the CCT

has been completed by both the Peterborough Health Link and Durham North East Health Link

in collaboration with Health Link partner organizations and submitted to Orion Health, the CCT

vendor. These documents have also outlined many of the improvement recommendations for

the MOHLTC to consider. The Peterborough Health Link and Durham North East Health Link

have also provided feedback on CCT implementation and support provided by Orion Health to

Power Analysis, a third party evaluator contracted by the MOHLTC. Frontline staff who utilize

the CCT were also invited to provide their feedback with Power Analysis and the Central East

CCAC was a primary contributor to this exercise.


Coordinated Care Tool Interim Solution

Since two of the Central East Health Links have access to an electronic solution as provided

by the MOHLTC, it has become evident that the remaining five Health Links will also require

an interim solution until the Ministry has determined which solution will become the provincial

standard. Timelines for the full implementation of the provincial solution, which include roll

out, onboarding and scheduling, is estimated to have the Central East Health Links onto the

electronic system between 18 – 24 months. Given these timelines, the Ministry has supported

the development of an interim solution. The Senior Team of the Central East LHIN has

approved the release of Central East Health Links funds to the Ontario Association of

Community Care Access Centres (OACCAC) to proceed with development of enhancing Client

Health and Related Information System (CHRIS) and enabling the Health Partner Gateway

(HPG) so that Central East Health Link partnering organizations can have an interim electronic

based system to facilitate care planning and discontinue the use of paper-based coordinated

care plans. The interim solution will also ease the migration to the provincial standard as

partners will become more familiar with developing processes and working together in an

electronic environment with coordinated care plans. The Central East CCAC will be an integral

partner of developing and spreading the use of the HPG within CHRIS since the solution is

housed within the OACCAC. Five other CCAC’s within the province are currently developing or

using CHRIS for Health Link purposes.


Strategic Goals

Optimize Health Outcomes ☐ Balance Our Budget






Workplaces

☐



based Care


Environments

☐


☒ Be an Innovative Learning Organization


☐ Enable Service Excellence ☒

Finance Report

The CECCAC is on target toward a balanced position at year end. The December 2015 Base

surplus was $1.5M which reduced the Base YTD deficit at December 31, 2015 to ($4.8M).

The positive December financial position is a combination of our ongoing attention to the

mitigation strategies and the infusion of new Base and One-Time funding.


The Central East CCAC has growing waitlists for personal support and therapy services with

about 2,238 waiting for personal support, 921 waiting for enhanced personal support and 269

waiting for therapy services at December 31, 2015. These patients are receiving case

management support and referrals to other community supports where applicable.

The Central East CCAC has little room to realize further efficiencies to allow us to meet the

needs of our patients. Growth in patient numbers and service volumes is inevitable. In

2015/16 we were able to offset growth through the strategies that were implemented to

facilitate a projected balanced positon at year end. Regrettably, some of those strategies

resulted in personal support and enhanced personal support waitlisted patient numbers

increasing and initiation of waitlists for adult therapy patients.

Our strategic focus for the future will be on how to increase the base budget relative to other

CCACs, rather than on what we need to reduce to balance.


Strategic Goals


☒ Develop Our People ☐





Workplaces

☐



based Care


Environments

☐





Outstanding Place to Work Build on the strengths, expertise and leadership capacity of our people and continuous quality

improvement in a healthy, safe and energized workplace.

WSIB/Safety

CECCAC participates in the New Experimental Experience Rating (NEER) Program run by the

Workplace Safety and Insurance Board (WSIB). In the NEER program, you can either earn

lump sum refunds or surcharges based on your individual accident performance. If you have

a good accident cost record, your firm will be refunded a portion of the paid premium. For

the 3rd year in a row, the CECCAC received a refund and over the past 5 years, CECCAC has

received over $490,000.00 in WSIB refunds. For 2015 our rebate cheque totaled $88,840.00.

Over the past 5 years, the CECCAC’s most common incident type continues to be slips, trips

and falls accounting for almost 40% of all work-related accidents. To help limit the number of

these types of incidents, we have a policy regarding slips, trips and falls and education at

orientation as well as online through our Talent Management System (TMS). The next three

most common incidents are due to repetition, overexertion and motor vehicle incidents. We


have policies, programs and training to help eliminate or control workplace hazards and to

keep all CECCAC staff healthy and safe.

In 2015, we once again participated in an incentive program known as Safety Group run by

the Public Services Health and Safety Association (PSHSA) and the WSIB. The program is

designed to recognize businesses that make the prevention of workplace injuries and illnesses

a daily habit by building it into their management systems. Over the past 4 years, we have

received over $90,000.00 for being a part of this group.


Strategic Goals







Workplaces

☒



based Care


Environments

☐





of 3

Performance Quality and Effectiveness Committee

Meeting

Wednesday, February 3, 2016

Central East CCAC - Whitby Branch, Durham Room

6:30 p.m. – 8:30 p.m.

MINUTES

Present: Nicola Crow (Chair), Carmen Nisbet, Derrick McLennon, Len Lifchus, Don Ford,

Kathryn Ramsay, Kathy Romas Jaeger, Dave Stringer, Lisa Burden, Paul Scobie (guest),

Dave Merkley (guest), Wanda Parrott (guest), Jill Ritchie (guest)

Regrets:

Recorder: Christine Lomas

1. Meeting Agenda and Approval

1.1. Call to Order

Meeting was called to order at 6:28 p.m.

1.2. Declaration of Quorum

Quorum was met

1.3. Approval of Agenda

MOTION: To approve the proposed modified agenda, moving items 3.1., 3.2., 2.2.,

and 2.3. prior to 2.1.

MOVED: Carmen Nisbet

SECOND: Derrick McLennon CARRIED

1.4. Declaration of Conflicts

No conflicts were declared.

1.5. Approval of Minutes for December 2, 2015

MOTION: To approve the minutes of the December 2, 2015 PQE Committee

meeting.

MOVED: Derrick McLennon

SECOND: Carmen Nisbet, CARRIED

2. Business Arising

2.1. Q3 2015/16 Organization Performance Report

2.1.1. Report Discussion—Kathryn Ramsay

An overview of the report was given and attention drawn to several of the results.

2.1.2. Identification of Follow-Up Discussion Metric—Kathryn Ramsay

of 3

A decision was made to have a presentation dedicated to what the implications will

be going into next year knowing there will be growth, but entering the new fiscal

year with the budget challenges of this fiscal year. Once presented to the PQE

Committee in March, Committee members asked that it be presented at the full

Board meeting in April as the Generative Board Discussion item.

ACTION: Dave Stringer to present at the March, 2016 PQE Committee meeting and

the April 2016 Board Meeting. Christine Lomas to inform Robin Russell of the April

Generative Board Discussion item.

2.2. Q1 Organizational Performance Report — Improvement Initiative —

OBRAM Reports – Wanda Parrott and Dave Merkley

Wanda Parrott and Dave Merkley provided a detailed overview on the Outcome

Based Resource Allocation Methodology (OBRAM) reports, and a new tool available to

Patient Services Managers to further support OBRAM accountability.

A new report tool was created through Decision Support for Patient Services

Managers to eliminate the manual work that was created by Wanda Parrot and being

done in Patient Services to provide more drilled down information by teams and

caseloads to support better understanding of variances in an effort to meet OBRAM

targets. Creating an electronic version dramatically reduced the workload required to

get the information and facilitated extension of the tool across all branches. A

demonstration of the report tool was given.

It was asked how the report will impact patients, and an example was given how on

how an analysis was done within a short stay team. A drill down was done on a

particular patient where the budget was quite high, and discussed by the Senior

Manager and Care Coordinator. The Care Coordinator met with the patient, identified

her needs in the face to face assessment, and a new plan was created together with

the patient which addressed the unmet needs which had been contributing to the

overage and resulted in realignment of that patient’s allocation.

Committee members were very impressed with the innovative work and extended

congratulations to Wanda and Dave for their excellent work.

2.3. Q2 Organizational Performance Report Improvement Initiative — Client

Care Model Analysis – Dave Merkley

Dave Merkley noted that he had been challenged to support the Decision Support

team to become experts in understanding our patients and their journeys. He

presented an overview a new Client Care Model analysis tool, which was created to

study our patients’ journeys across the various Client Care Model populations by

exploring such things as how stable the populations are, identifying any typical

progressions that take place and providing opportunities to learn from the

characteristics of patients that progress in certain ways. Dave Merkley noted that by

doing this, we can investigate interventions that may results in better outcomes and

promote stability/improvements. He noted that this supported the Decision Support

team’s strategic movement into predictive analytics where they will use data that

they have to predict data that they don’t have, identify characteristics of our patients

that are predictive of the journey they are likely to take and investigate

interventions that may result in better outcomes and promote

stability/improvements.

Committee members were also very impressed with Dave’s innovative work,

expressed ideas around the many opportunities the new tool and approach could

create, and extended congratulations to Dave for his excellent work.

of 3

3. New Business

3.1. Information Systems Plan Update – Paul Scobie

A technology update was provided to show how Information Systems supports and

advances technology to meet the needs of the organization. Paul Scobie noted that

three portfolios make up Information Systems and consist of Networking &

Telecommunications; Technology Solutions; and Information Management Systems.

He further highlighted that Information Systems not only supports the organization,

but they also work with external partners like the LHIN and many other health

service partners in the region providing technical support and/or training and

education. A brief overview of the Service Catalogue, Service Level Agreement,

Technology Outline and Security Systems were given (please refer to individual

documents for detailed information).

A discussion around branch and patient security followed and Paul Scobie shared the

processes and structures that are in place to provide the necessary and critical

security.

3.2. Diversity Culture Plan Update — Jill Ritchie

An update was provided on the Diversity Culture Plan, which was initially created

because of accreditation. The focus for 2016 is establishing a new Cultural

Competence and Diversity Committee to consider the needs of employees and

patients in the following areas: culture, age, gender, sexual orientation, and

language. Approximately 23 front line staff responded to an Expression of Interest to

participate on this committee. The first meeting will take place in March. A

committee member asked about the cultural diversity of the committee. It was noted

that the Expression of Interest had just been issued and the staff who expressed

interest have not been reviewed. Staff offered to provide an update on the cultural

diversity of the newly formed committee once the members have been confirmed.

Following a question regarding a policy and/or processes being in place for a staff

member or patient who feels that they are being discriminated against, a discussion

ensued about the policy and all of the process and structures in place to support both

staff and patients. Staff also noted that this issue is taken very seriously and that

actions taken have included dismissal where appropriate.

ACTION: Jill Ritchie will create a briefing note for the May PQE Committee meeting.

3.3. CECCAC 2016-17 Quality Improvement Plan — Kathryn Ramsay

An update was given on Quality Improvement Plan, which must be posted by April 1,

2016. Committee members were asked if they had any significant concerns, noting

that the final documents will be presented to the committee at the March meeting for

final approval, and then to the Board for final approval at its March meeting through

the PQE Committee report. Committee members did not express any concerns.

4. Standing Items

4.1 Messages to the Board—Nicola Crow

Highlights from Wanda Parrott’s and Dave Merkley’s presentations will be noted for

the Board.

4.2. Risk Management Update—Kathryn Ramsay

Kathryn Ramsay provided the Appeals/Claims Update.

Adjournment – Meeting adjourned at 8:36 p.m.

__________________________________ _____________________________

Nicola Crow (Chair) Date

Board Finance Committee Meeting –January 20, 2016 Page 1 of 3

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE FINANCE COMMITTEE MEETING

MINUTES January 20, 2015

6:30 p.m. Teleconference: Michelle Rawnsley (Acting Chair), Len Lifchus, Andy Williams,

Joe Bozec, Don Ford, Dave Stringer Absent: Patrick Connolly Recorder: Dave Stringer 1.0 CALL TO ORDER 6:40p.m.

1.1 Quorum Quorum was present.

1.2 Declaration Of Conflict (Policy Reference V-A-3) No declaration of conflict.

2.0 APPROVAL OF MEETING AGENDA MOTION: TO APPROVE THE AGENDA OF JANUARY 20, 2016 MOVED: Andy Williams SECONDED: Len Lifchus CARRIED

3.0 APPROVAL OF MINUTES

MOTION: TO APPROVE THE MINUTES OF DECEMBER 16, 2015 MOVED: Andy Williams SECONDED: Michelle Rawnsley CARRIED

4.0 BUSINESS ARISING (Action List) • Board Access to CECCAC Policy and Procedures –

The Network team is making necessary changes to the system. Once that change is completed, we will be able to arrange the Remote Access running for Board Member access. Target date is February 01, 2016

• Duration of the lease renewal for the Peterborough office – The landlord provided a 2-year lease renewal proposal with the same rate as the 5-year proposal. We have accepted the 2-year proposal.


5.0 NEW BUSINESS

5.1 Payment of Obligations Report This document shows at a glance that we are compliant with all of our payments, premiums, remittances and information requirements to external parties such as CRA.

5.2 Review Committee Terms of Reference Committee Terms of Reference are confirmed with one formatting change in Section 6.0 Accountability. ACTION: Yvonne Norris to make necessary formatting change to the Finance Committee Terms of Reference.

5.3 Vacation Compliance Report Work continues to minimize the number of staff with greater than 30 days accrued vacation. The next update in September is expected to include very few staff on the list.

5.4 Review Board Policies – Finance Committee Policies are confirmed for the next year with no change.

5.5 Review of High Level Financial Analysis We currently have a $4.8M deficit as of December 31, 2015. In Q4, the deficit reduction will be achieved through a combination of new funding and continuing results from the mitigation strategies. The CECCAC is on track to a balanced position at March 31, 2016.

5.6 Detailed Month/YTD Financial Package (Discussion by

Exception) The service volume reductions through Q3 and notably in the Christmas/New Year’s holiday were noted. The administration as a percent of total expense remains at about 6.7%.

5.7 Key Messages to the Board

On track to a balanced position. Funding letters are being received. The Organization is driving exceptional efficiencies. Waitlists continue to climb and meaningful progress on the waitlist will not happen without an appropriate funding strategy.


6.0 NEXT MEETING February 17, 2016 6:30 p.m. Teleconference

7.0 ADJOURNMENT OF MEETING MOTION: TO ADJOURN MEETING AT 7:17PM MOVED: Andy Williams CARRIED ___________________ __________________ Michelle Rawnsley, Acting Chair Date

CECCAC Board Audit Committee Meeting – Minutes: January 18, 2016 Page 1 of 3

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE AUDIT COMMITTEE MEETING

MINUTES

January 18, 2016 Start time: 5:30 p.m.

CECCAC Whitby Branch – Durham Room 920 Champlain Court, Whitby ON

Present: Rick Morphew (Chair), Derrick McLennon, Joe Bozec, Don Ford, David

Stringer Teleconference: Carmen Nisbet Guests: Nigel Allen – BDO, Victoria Hennessy - BDO Recorder:

1.0 CALL TO ORDER – 5:32PM

1.1 Quorum Quorum was present.

1.2 Declaration Of Conflict (Policy Reference V-A-3) No declaration of conflict.

2.0 APPROVAL OF AGENDA MOVE TO ACCEPT: Derrick McLennon SECOND: Carmen Nisbet CARRIED

3.0 APPROVAL OF MINUTES MOTION: TO APPROVE THE MINUTES OF JUNE 04 & JUNE 10, 2014 MOVE: Rick Morphew SECOND: Derrick McLennon CARRIED MOTION: TO APPROVE THE IN CAMERA MINUTES OF JUNE 04, 2014 MOVE: Rick Morphew SECOND: Derrick McLennon CARRIED

4.0 NEW BUSINESS 4.1 Audit Committee – Terms of Reference The Terms of Reference for the Audit Committee were discussed. MOTION: TO APPROVE THE TERMS OF REFERENCE AS TABLED MOVE: Carmen Nisbet SECOND: Derrick McLennon CARRIED 4.2 BDO Audit Committee Planning Report and Discussion General Overview Nigel Allen provided a brief overview of the audit process and noted that at the end of the audit a Management letter will be presented highlighting any recommendations if there should be any. He also noted that two (2) smaller audits are performed for the Centre for Complex Diabetes Care (CCDC) and the Self-Management Program, Ontario Diabetes Strategy (ODS).


Planning Report to the CECCAC Audit Committee Nigel Allen provided an overview of the Audit Committee Planning Report highlighting key points.

• Nigel reviewed the Responsibilities section of the document briefly discussing and comparing the differences between Management and Audit Committee responsibilities.

• BDO will perform a risk based audit allowing them to focus on higher risk areas

and areas of concern for management and the Audit Committee. BDO has to gain a good understanding of the organization and the internal controls.

• The acceptable percentage of materiality is 2%. The auditors confirmed that they will communicate all errors under the 2% if they feel they are important as well as document them in their final report.

• Nigel conducted a fraud discussion with the committee followed by two questions.

Are there any new processes or changes in existing processes relating to fraud that we should be aware of? AUDIT COMMITTEE RESPONSE – The Audit Committee reported that there are no new processes or change in processes that they are aware of at this time.

Are you aware of any instances of actual, suspected or alleged fraud affecting the Organization? AUDIT COMMITTEE RESPONSE – The Audit Committee reported that there are no known instances or concerns.

• Two-way open communication is important to the success of the audit. For your

convenience BDO’s contact information is listed in the Audit Planning Report.

• Risks and planned audit procedures were discussed. It includes reviewing revenue recognition, deferred contributions and the use of estimates.

• BDO reviewed the independence letter confirming they are independent with

respect to the organization.

Tentative Time Table

• Interim Audit (partial testing, understanding systems): o February 29 – Mar 04 2016.

• Full Audit: o Commences on or about May 09, 2016

MOTION: TO ACCEPT THE AUDIT PLANNING REPORT AS CIRCULATED. MOVED: Carmen Nisbet SECONDED: Derrick McLennon CARRIED


5.0 OTHER BUSINESS

The AGM is scheduled for June 28, 2016. 6.0 IN CAMERA SESSION

No in camera session required.

7.0 NEXT MEETING – to be determined 8.0 ADJOURNMENT – 5:54PM

_________________________ ________________________ Rick Morphew, Chair Date

Central East CCAC Governance Committee – January 14, 2016 Page 1 of 3

MEETING OF GOVERNANCE COMMITTEE Wednesday, January 13, 2016

5:00 p.m.

MINUTES

Present: Gary Lounsbury, Sylvia Patterson, Glenn Rogers and Len Lifchus Recorder: Don Ford

1. Call to Order Gary Lounsbury called the meeting to order at 5:00 p.m. and welcomed Sylvia Patterson to her first Governance Committee meeting.

2. Quorum

A quorum was present.

3. Approval of Agenda

MOTION: TO APPROVE THE AGENDA OF JANUARY 13, 2016 MOVED: Glenn Rogers SECOND: Sylvia Patterson CARRIED

4. Declaration of Conflicts G. Lounsbury asked for any declaration of conflicts. None were declared

5. Approval of the Minutes of previous meeting

MOTION: TO APPROVE THE MINUTES OF OCTOBER 14, 2015.

MOVED: Len Lifchus SECOND: Glenn Rogers CARRIED


6. Business Arising

6.1. Board Retreat / Education Session

G. Lounsbury led the Committee discussion regarding the annual Board

Retreat / Education session.

MOTION: TO CONFIRM THAT THE DECISION OF THE BOARD

REGARDING POSTPONING A STRATEGIC PLANNING

EVENT BE ACCEPTED GIVEN POTENTIAL

INTEGRATION ACTIVITIES THAT ARE IMMENENT

MOVED: Len Lifchus

SECOND: Sylvia Patterson

7. New Business 7.1. Board Terms

L. Lifchus noted that with the pending transition activities, it is proposed that the two members whose terms are at completion be left vacant, and review this proposal as the details about transition become clearer. The Committee also confirmed that the CECCAC Annual General Meeting will take place June 28, 2016.

7.2. Review Board Effectiveness Evaluation, Director Self-Evaluation, Board Committee Evaluation and Board Meeting Evaluation Tools

G. Lounsbury confirmed the importance of continuing with business as usual and to proceed with evaluations as scheduled.


7.3. M-SAA Discussion

G. Lounsbury advised that there are no actions required at this point, save the submission of the CAPS document to the Central East LHIN.

8. Other Business

No other business

9. Next Meeting

February 10, 2016

10. Adjournment MOTION: To adjourn the meeting at 5:25pm. MOVED: G. Rogers

____________________ ___________________

Gary Lounsbury, Chair Date

central east ccac board...

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