collaborative governance webinar

Collaborative Governance: A Model for Service System IntegrationBob Morton, Chairperson, North Simcoe Muskoka LHIN

Glen Newby, CEO, New Path Youth and Family Services

Steve Lough, Lough Barnes Consulting Group

The context for collaborative governance in human services

The collaborative governance model in the North Simcoe Muskoka LHIN

Collaborative governance in Simcoe Child and Youth Mental Health

Discussion

Overview

March 8, 2017 CMHO Collaborative Governance Webinar 2

Clients, families and funders want service providers across human services to work as integrated service systems to better meet their needs with:

⁄ Coordinated access so that people know where to go

⁄ Consistent services regardless of where a client is served

⁄ Smooth hand-offs between services and providers

⁄ Best practices used wherever a client is served

Government has responded in several sectors by establishing:

⁄ Local Health Integration Networks in health care

⁄ Lead agencies in child and youth mental health

⁄ “Collaboratives” in adult mental health

⁄ Networks of Specialized Care in developmental services and mental health

⁄ Provincial agencies such as:

⁄ Ontario Centre of Excellence in Child and Youth Mental Health

⁄ Health Quality Ontario

From “Services” to “Service Systems”


Diagram: John Kania & Mark Kramer, Stanford Social Innovation Review 2011

Why Collaborative Governance is Needed?

March 8, 2017 CMHO Collaborative Governance Webinar

⁄ All players have to change to achieve the desired outcomes

⁄ Contractual relationships require us to pursue integration

⁄ Board’s set direction and measure performance against objectives

⁄ Boards can’t do a good job of strategic and generative governance without engaging in collaborative governance

⁄ It is in the best interests of the people we serve

Collective Impact

4

Collaborative governance is and is not!

.

Is NOT… IS…

Board-level merger or integration

Multiple Boards partnering together to collectively achieve results for shared stakeholders

A “Super Board”Less about structure and more about process, relationships and communications

An additional level of governance

A response to the demand for greater integration and partnerships amongst providers.

Competition among peers

Collaboration among stakeholders to meet the needs of shared populations


Collaboration – 4 Ts

http://www.actforyouth.net/youth_development/communities/collaboration.cfm

It takes Time to build Trust through Transparency to address Turf


Examples of Collaborative Governance in Ontario LHINs

• North Simcoe Muskoka LIHN• Mississauga Halton LHIN

Care Connections Implementation Structure Current State

7.Communications

and Community

Engagement

8. Governance9. Information

Communication

Technology/ eHealth

10. Integrated

Health Human

Resources

11. System

Navigation12. Transportation

Complex Continuing

Care

Chronic Disease

Prevention and

Management

Behavioural Support

System

1. Complex &

Chronic Health

Needs

GBGH

Seniors’ Care

Strategy

Community

Capacity Task

GroupsHigh User Analysis;

LTC Capacity; and

Assisted

Living/Supportive

Housing

2. In Home &

Community

Capacity

CCAC/ILS

Developmental

Services

3. Maternal

Newborn Child &

Youth / COP

OSMH

Child & Adolescent

Mental Health &

Addictions

Acute Care Clinical

Services

Crisis Response

and Community

Resources

4. Mental Health

& Addictions

Waypoint

Critical Care System

Integrated Vascular

Care System

Emergency Care

System

5. Medicine

RVH

Musculoskeletal

Program

6. Surgery

CGMH

LHIN LHIN LHIN LHIN CCAC County of Simcoe

Inter-facility

Community

Standardization of

Process and Policy

Information &

Referral

Organizational

Development

Workforce Planning

and Education

Recruitment and

Retention

Transitions of Care

Maternal Child

Standards

Maternal Mental

Health

NSM LHIN Leadership Council &

Care Connections Steering Committee

Care Connections Operations Committee

Legend

Lead Organizations

Coordinating Councils

System Enablers

Project Steering

Committees

Regional Cancer

Includes 41 distinct

projects

Integrated Regional and Sub-LHIN Regional Model (Future State)

Sub-LHIN Integrated Delivery and

Coordination Management Team

Priority

Collaborating

Councils (for LHIN-

wide Integrated

Programs & Specialty

Services)

Enabling Councils

Provincial Programs

Leadership

Standards

Resource

Allocation

Oversight

Delivery

Primary

Health Care

Leadership Council

Patient and

Family

Self-Care

Longer-Term Care

Post-Acute Care

Acute Care

Commu-nity

Services

LHIN Oversight

Future State

Service Delivery

Model

Core Collaborating

Councils (for LHIN-

wide Integrated

Programs & Specialty

Services)

Leadership

Standards

Resource

Allocation

Oversight

Delivery

As in the MH LHIN, early work identified the need for governance training

Provided Governance 101 and now 201 at a LHIN-wide level

Using the sub-regions of the LHIN as the basis for the governance discussions

System planning is at the sub-region level and each is taking a different path

Muskoka: MAHST Charting the course…Integrating Health Care

South Georgian Bay: Regional alignment of Quality Improvement Plans

North Simcoe Muskoka LHIN


Mississauga Halton LHIN

March 8, 2017 11CMHO Collaborative Governance Webinar

Community

Governance

Consultation

Group

G2GRegional

Quality Table

LHIN-CCAC

Joint

Assessment

Reports to the

LHIN Governance

Committee

Provides input into

the agenda for

quarterly G2G

Provides advice on

LHIN priorities (i.e.

IHSP and

accreditation.

HSP Board and

CEOs with

LHIN Board and

Senior Team

Generative

discussions –

Educational

component with

guest speakers

Developing integrated regional quality plan Building a culture of quality careFostering innovation Building capacity

Undertook joint assessment of the LHIN-CCAC interactions including budget development, multi year planning, and common projects

• Initiated Governance to Governance (G2G) very early on.

• A forum to foster interaction of health service providers with each other and

the LHIN and promote education and trust.

• Participants: HSP Board Members and Executive Directors/CEOs with

LHIN Board Members and Senior Team

• Started with an independent Facilitator but now use LHIN staff.

• Intermingled seating plan with a LHIN board and or staff member at each

table for more engaged and constructive conversations.

• Generative discussions – opportunity for open, interactive dialogue.

• Educational component with guest speakers followed by a staff facilitated

discussion at the individual group table level.

MH LHIN G2G


Collaborative Governance in Child and Youth Mental Health

Capitalize on Previous Collaborative Governance AssetsCoalition of Child Youth and Family Services (40 member agencies/services)established in 1999, including previous Board to Board engagements.

Purpose of Current Moving on Mental Health (MOMH) Collaborative Governance1. Catalyze collective board involvement and responsibility for System Change.2. Embed MOMH ownership in community governance, not just Lead Agency.

3. Develop and “live” a common vision for child and youth mental health.

Collective Governance ProcessFirst Session with Core Service Providers Board reps: Initial vision development for CYMH in the service area, updates on the core services plan and potential priorities for the two plans.

• Wanted to make sure the boards received updates directly from the Lead Agency

• Discussion was wide-ranging, which was goodSecond Session: shared and analyzed strategic plans from 5 core service providers, seeking common visions and strategies, as well as strategic gaps.

• Established a portal for board members to access information

Planned Third Session: Open up the engagement process to other non-core service but allied providers: Hospital Board, LHIN Board, School Board Trustees, etc• Linkage of common visions, yielding a Simcoe County vision for child and youth mental

health

Simcoe County Lead Agency Experience


Just Do It! Board members are keen to meet colleagues from other agencies!

► Keep the sessions open to all board members rather than asking for a designated representative; Senior Staff representation is welcome;

► Ensure the process is governance organized and sustained;

►Keep discussions at a high level as opposed to discussions of specific issues in each agency; focus on the common vision and mission for CYMH;

►This will help when difficult decisions need to be made about services later;

►Value Added: Some agencies said that they have difficulty recruiting; so they are considering sharing board members;

►Started with Saturday mornings to help with board member access;

►Important to have good independent facilitation so everyone participates;

►Anticipated outcomes are similar to Collective Impact but more of a “developmental” approach.

Simcoe County Lessons


How does this information compare to what is developing in your region?

How much time does your board spend on systems versus organizational priorities?

How much time should your board spend on systems versus organizational priorities?

What about your CEO? How much time and effort is reasonable for your CEO to spend on system issues/priorities?

What does this mean for your Board?

Does your Board need to do anything different?

Discussion


LOUGH BARNES CONSULTING GROUP439 University Ave., Suite 1920

Toronto, ON M5G 1Y8T/ 416.977.3811

www.loughbarnes.ca

We are creative and dedicated professionals with strong social values and a commitment to our communities, especially to those who are most vulnerable.

Our vision is to build stronger communities through positive social change, a collaborative approach and our Social Investment Fund.

Our mission is to contribute to improving human services through high quality consulting and our Social Investment Fund.

http://www.loughbarnes.ca/

collaborative governance webinar

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