Hospital Accountability Planning Submission (HAPS) Process

Fiscal 2016/17

Presented in Fall 2015

Agenda1. Context2. HSAA Organizational Structure3. Guiding Principles4. Differences between 2015-16 and 2016-17

• HAPS Submission Timelines

• HAPS Guidelines

• Additional Updates5. Projected Timelines for 2016-176. Planning for Key Variables7. Planning Environment Considerations8. Assumptions9. Appendix A: HSAA Planning & Schedules WG Membership10. Appendix B: SRI Reports WG Membership11. Questions

Context

Planning for 2016/2017

• The HSAA Template Agreement is envisioned to be a multi-year agreement established through consultative stakeholder meetings between the LHINs, hospitals, the OHA and MOHLTC. The Schedules content will be negotiated annually.

• Information collected through the Hospital Accountability Planning Submission (HAPS) and the Additional Input forms will be used to populate the HSAA Schedules. Both the HAPS forms and the guidelines have been refreshed.

• The HAPS and related draft Schedules will cover one fiscal year (FY 2016/17).

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Context Planning for 2016/2017

• The government continues to implement Health System Funding Reform (HSFR), which supports system capacity planning and quality improvement through directly linking funding to patient outcomes. LHINs and the hospitals recognize that HSFR will impact the HSAA process.

• Hospital funding has become unique to each individual hospital with the roll out of the Health Based Allocation Model and Quality-Based Procedure Funding (QBP) and so “across the board” planning targets are no longer relevant or possible.

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Context Planning for 2016/2017

• Hospitals are currently engaged in developing budgets to guide operations for fiscal 2016/17 as part of their organization’s fiduciary duty, and hospital services will continue to be provided to patients according to the hospital’s internal plan and based on the hospital’s best assumptions.

• There is great benefit for hospitals and LHINs to agree on performance expectations within a set of parameters that begins on day one of the fiscal year. The vehicle for this agreement is the HSAA.

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HSAA Organizational StructureCreating an ownership framework

Hospitals(OHA)

HSAA Steering Committee

HSAA Planning & Schedules

Work Group

SRI Reports

Work Group

HSAA Indicator

Work Group

LHINs

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HSAA Organizational StructureCreating an ownership framework

• The HSAA Planning & Schedules Work Group is co-led by Sherry Kennedy, Chief Operating Officer of the South East LHIN, and May Chang, Executive Vice President, Strategy & Patient Experience, Markham Stouffville Hospital. The SRI Reports Work Group is led by Pete Crvenkovski, Director of Performance Quality & Knowledge Management at Erie St. Clair LHIN.

• Based on the HSAA Steering Committee’s planning assumptions, the core deliverables of the HSAA Planning & Schedules Work Group were to prepare draft schedules and planning submission documents and produce related education materials.

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Guiding Principles

Developing the HAPS materials

The deliverables of the Planning & Schedules Work Group were set with the following guiding principles in mind:

1. Practicality - Develop products that reflect our current reality and are easy to use/understand.

2. Emphasis on local within the provincial context - For planning targets, performance indicator targets and other health system changes.

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Guiding Principles

Developing the HAPS materials

3. Partnership Approach - Hospitals and LHINs should liaise early and often in order to develop a mutually acceptable HSAA within the requisite timeline.

4. Ensure alignment. All core HAPS/HSAA materials (Guidelines, Forms and Schedules), should align with one another. The Work Group will also strive for enhanced functionality whereby one form/schedule may be pre-populated by another where appropriate.

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Differences between 2015-16 and 2016-17

HAPS Submission Timelines• Over the past few years the HAPS document has had a due date in

January.

• This often resulted in an abbreviated review of the submissions by the LHIN resulting in multiple production runs of the schedules due to changes.

• The additional time afforded to the Hospitals did not make a significant difference in the value of the HAPS plan in the overall HSAA agreement.

• Most Hospitals begin their planning process in September to allow time to implement changes in cost structures.

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• A standardized Work plan has been endorsed by the LHIN CEOs and will be implemented in 2016-17 to provide predictable dates for key deliverables for all future years.

• For 2016-17, the HAPS submission is due on Monday November 23rd, 2015 .

• The LHINs do not consider the submission on the 23rd to be final as changes usually occur post submission up to January through the LHIN review process.

• The final HAPS is approved by Hospital Boards in January 2016.

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Differences between 2015-16 and 2016-17

HAPS Submission Timelines

• Updates to the HAPS Guidelines include:

• New content regarding Provincial Interest Programs• Sexual Assault Clinics • Embedded a hospital listing in the Narrative to guide

hospitals through the completion of Section 2a and 2b

• Standardized the submission process through SRI for the HAPS Narrative and the Additional Input file

• Embedded within these documents are instructions on how to enable SRI submission.

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Differences between 2015-16 and 2016-17

HAPS Guidelines

• The Additional Input Form has been reduced in length

• HAPS narrative updated• Includes a new Narrative for Hospitals with Sexual Assault Clinics

• There is a new Supplemental reporting Tab in the HAPS for LHIN use (hospitals should ignore this when submitting)

Differences between 2015-16 and 2016-17

Additional Updates

Activity Time FrameHAPS Completion• HAPS on SRI• HAPS Narrative (submit as document through SRI)• HAPS Additional Input (submit as document through SRI)

Oct 1/15 to Nov 23/15

HSAA Launch (Local)• Local Education• Draft Local Indicators & Performance Targets to Hospitals

Nov 10/15 to Nov 16/15

Local Indicators & Performance Targets Negotiated & Finalized Nov 23/15 to Dec 18/15

LHIN prepares the Hospital Agreements and Schedules & sends for Hospitals for Feb 1/16

Jan 15/16 to Feb 1/16

Provincial Update Dec 1/15 to Dec 4/15Hospital Boards approve HAPS Jan 1/16 to Jan 31/16Hospital Boards approve HSAA agreement and returned signed copies to LHIN

Feb 1/16 to Mar 31/16

Projected Timelines for 2016-17HAPS and HSAA

Planning for Key VariablesHAPS

• Key variables to consider when completing the HAPS

include:

• Mitigation

• HBAM

• QBPs

• Breaking the cycle of Rework

• The Mystery of Funding

• Scenario Planning

• It’s just a “Plan”

• Timelines

Planning Environment ConsiderationsHAPS

• Hospitals will individually and locally determine reasonable planning assumptions for use in the completion of the 2016-17 HAPS.

• Use information currently available including assumptions for HBAM and Quality Based Procedures.

• The LHIN will review assumptions for reasonableness.

• In some LHINs, the LHIN and hospitals may collectively agree on a common set of assumptions.

AssumptionsHAPS

Sector Organization Individual, TitleLHIN SE LHIN Sherry Kennedy, COO (Co-Chair)

Hospital Markham Stouffville Hospital May Chang, Executive VP, Strategy & Patient Experience (Co-Chair)

Hospital Collingwood General & Marine Hospital Michael Lacroix, Vice President, Corporate Services & CFO

Hospital North York General Hospital Deepak Sharma, Director, Decision SupportHospital Red Lake Margaret Cochenour

Memorial HospitalPaul Chatelain, Former President and CEO

Hospital St Michael’s Hospital Tomi Nieminen, DirectorHospital Trillium Health Partners Carol Vinette-Hancharyk, Director, Financial Strategy &

Deputy Chief Financial OfficerMOHLTC Ministry of Health and Long-Term Care Maria van Dyk, Team Lead

OHA Ontario Hospital Association Imtiaz Daniel, Director, Financial Analytics and System Performance

Appendix A: HSAA Planning & Schedules Work Group Membership

Sector Organization Individual, TitleLHIN CH LHIN Elizabeth Woodbury, Senior Accountability SpecialistLHIN MH LHIN Andrew Wahab, Senior Lead of Funding and AllocationLHIN NE LHIN Marc Demers, Controller / Corporate Services ManagerLHIN NE LHIN Joan Tonon, Data Analyst LHIN NW LHIN Kevin Holder, Senior ConsultantLHIN SE LHIN Mike McClelland, Senior Financial AnalystLHIN SW LHIN Scott Chambers, Team LeadLHIN SW LHIN Betty Wang, Financial AnalystLHIN TC LHIN Chris Sulway, Senior ConsultantLHIN MH LHIN Laura Salisbury, Executive Lead (Observer)

Appendix A: HSAA Planning & Schedules Work Group Membership (cont’d)

Appendix B: SRI Reports Work Group Membership

Sector Organization Individual, TitleLHIN ESC LHIN Pete Crvenkovski, Director, Performance Quality &

Knowledge Management (Executive Lead)LHIN ESC LHIN Jean-Francois Gauthier, Performance & Finance AnalystLHIN CW LHIN Chak Lee, Financial AnalystLHIN MH LHIN Andrew Wahab, Senior Lead, Funding and AllocationLHIN NE LHIN Joan Tonan, Data AnalystLHIN NW LHIN James Anderson, Performance and Contract Management

ConsultantLHIN TC LHIN Greg Stevens, Senior Consultant, Performance

ManagementLHIN TC LHIN Mohamedraza Khaki, Consultant Performance

Measurement & Information

Questions about the HAPS?

Please contact your local LHIN.