County of Simcoe 1110 Highway 26, Midhurst, ON L9X 1N6

Main Line 705-726-9300 Toll Free 1-866-893-9300 Fax 705-792-5743 simcoe.ca

MINUTES

SUBJECT: Age-Friendly Community Project Steering Committee MEETING DATE: March 21, 2017 TIME: 10:00 a.m. – 12:00 p.m. LOCATION: Simcoe County Council Chambers (1110 Highway 26, Midhurst, ON L9X 1N6) CHAIR: Jane Sinclair, General Manager, Health and Emergency Services ATTENDANCE: Amanda Flynn, Deputy Clerk, Statutory and Cultural Services, County of Simcoe Christy Tosh, AFC Project Coordinator, County of Simcoe Christina Strong, Public Education Trainer, Independent Living Services Simcoe Gayle Hall, Chief Librarian, County of Simcoe Margaret Adolphe, Seniors Representative Ron Coutts, Senior's Representative Rosslyn Junke, United Way Greater Simcoe County Sandi Robinson, Real Estate Manager, Procurement, Fleet & Property, County of Simcoe Sarah Orr-Shaw, Public Health Nurse, Simcoe Muskoka District Health Unit Scott Warnock, Councillor, County of Simcoe Susan Plewes, Community Representative Terri Soukup, Director of Client Services, Helping Hands Orillia Tom Johnston, Branch Manager, Seniors for Seniors (Simcoe-Muskoka) Regrets: Arfona Zwiers, Director of Social Housing, County of Simcoe Asa Klint-Piggott, Coordinator, Research and Project Management Connie Sheridan, Administrator, Georgian Manor David Parks, Director of Planning, Development & Tourism, County of Simcoe Denise Hayes, General Manager, Southern Georgian Bay Chamber of Commerce Elizabeth Ozga, Divisional Controller, Finance, County of Simcoe Greg Bishop, General Manager, Social & Community Services, County of Simcoe Heather Hollingshead, Regional Services Coordinator, Spinal Cord Injury Ontario Jim Gough, Senior's Representative Karen Taillefer, Vice President, Patient Services, NSM CCAC Kelly Swift-Jones, Museum, County of Simcoe Laura-Lynn Bourassa, Alzheimer’s Society Linda Flemington, Chair, CARP, Georgian Bay Mary Small Brett, Councillor, County of Simcoe Melissa Mei, Planning, Integration, Evaluation & Community Engagement, NSM LHIN Meredith Morrison, Deputy Chief, Quality Programs, County of Simcoe Paramedic Services

1.0 WELCOME AND INTRODUCTIONS Jane Sinclair, General Manager of Health and Emergency Services welcomed the group and provided a brief overview of the day.

County of Simcoe 1110 Highway 26, Midhurst, ON L9X 1N6

Main Line 705-726-9300 Toll Free 1-866-893-9300 Fax 705-792-5743 simcoe.ca

2.0 APPROVAL OF AGENDA The agenda was approved as presented.

3.0 APPROVAL OF MINUTES The minutes from the February 21, 2017 meeting were approved as presented.

4.0 WHAT’S HAPPENING (local community initiatives) - ROUNDTABLE A roundtable discussion took place regarding local community initiatives. A summary of the discussions are below:

a) At next week’s Committee of the Whole meeting a motion will be brought forward for the County of Simcoe to allocate through the County’s Affordable Housing, $2 million for the next two (2) years to small rural and urban settlement areas.

b) A discussion took place regarding the rising prices in the housing market and lack of affordability.

c) A discussion took place regarding the number of people headed to long term care. There are currently 4000 Alternate Level of Care (ALC) patients in Ontario awaiting a Long Term Care (LTC) LTC beds.

d) Helping Hands announced that they will be opening twelve (12) transitional beds from hospital in Barrie by October 2018.

e) The Simcoe Muskoka Integrated Fall Strategy (SMIFS) has been approved for $25,000 in funding from the New Horizons grant to initiate a Cyber Seniors Program. Staples Business Depot has graciously agreed to provide 40 iPads at a cost of 20 iPads.

f) The Simcoe County Alliance to end Homelessness (SCATEH) is looking at how to redistribute existing funds.

g) National Access Awareness Week takes place from May 29 to June 4, 2017. Independent Living Services has been invited to Clearview Township, Tay Township, Bradford West Gwillimbury and Orillia to provide the “Make your House a Home” presentation.

County of Simcoe 1110 Highway 26, Midhurst, ON L9X 1N6

Main Line 705-726-9300 Toll Free 1-866-893-9300 Fax 705-792-5743 simcoe.ca

5.0 SPECIALIZED GERIATRIC SERVICES PRESENTATION

County Age Friendly Committee

Sandra Easson-Bruno, Director of Specialized Geriatric Services (SGS) for the North Simcoe Muskoka Local Health Integration Network provided the attached presentation Specialized Geriatric Services. The goal of the program is to have services available in each of the sub-regions as well as central services for all to access. A summary of the discussions are noted below:

a) Waypoint Centre for Mental Health has the largest medical library north of Toronto. The Waypoint Library will be added to the Age-Friendly distribution list.

b) Multi-generational homes can be cultural. c) A presentation from the Elder Abuse Network will be scheduled for a future

meeting. 

Schedule Elder Abuse Network for future presentation.

6.0 AFC TERMS OF REFERENCE The Terms of Reference (TOR) were reviewed by the group. A summary of the recommended revisions and discussions that took place are outlined below.

a) The existing Age-Friendly Community Project Steering Committee will be reconstituted as the Age-Friendly Communities Advisory Table to ensure continued focus and support of our older adults across this region.

b) Christy will prepare a report recommending County Council appoint Councillors Scott Warnock and Mary Small-Brett to continue with their role in AFC planning as members of the newly shaped AFC Advisory Committee.

c) Meetings will be held bi-monthly (every two months), with additional meetings held on an as needed basis, as determined by the chair. The next meeting will be May16th and the Committee will break for July and August.

d) Christy to contact the NMS LHIN regarding a representative francophone and aboriginal’s representative and also extend an invite to have a representative from local Senior’s Advisory Committees.

e) Christy to extend an invite to the cities of Orillia and Barrie welcoming them to appoint a Council member or staff representative to sit on the newly formed AFC Advisory Committee.

Christy to prepare report to County Council. Christy to extend Committee invites to reps for the following: francophone, aboriginal, seniors advisory, Barrie and Orillia.

7.0 NEXT MEETING: The next meeting will be Tuesday, May 16th from 10:00 a.m. to 12:00 p.m.

8.0 ADJOURNMENT: 12:00 noon

NSM Specialized Geriatric Services

Program

Simcoe County Age-Friendly Steering Committee

March 21, 2017

Outline

• History

• LHIN Action Plan

• Progress

• Notable Numbers

• Key Messages

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Simcoe Muskoka District Health Council:• Simcoe County Geriatric Care Discussion Paper (1998)

• Recommendations for an Integrated Approach to Service Development:

Specialized Geriatric Services Working Group (2000)

• Directions for Seniors Health Services in Simcoe County (2003)

• Long-Term Multi-Year Plan: Strategic Priorities - Seniors in Simcoe County (2004-

2009)

• Specialized Geriatric Services in the Central East Region (2005)

NSM LHIN:• NSM Call to Action Symposium – Plan-to-Plan: Understanding the Frail Elderly in

NSM (2006)

• NSM Integrated Geriatric System Think Tank (2007)

• Vision for an Integrated Regional Seniors Health Program in the NSM LHIN (2009)

History

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• Elder Abuse Network, Dementia Network, Simcoe Muskoka

Integrated Falls Strategy

• Senior Friendly Hospital Strategy (SFHS)

• Integrated Regional Falls Program (IRFP), Seniors Assessment Support

& Outreach Team (SASOT), First Link, Primary Care Geriatric Outreach

• Nurse-Led Outreach Teams into LTC (NLOT)

• Behaviour Support System (BSS)

• Specialized Geriatric Services at OSMH and RVH

• Memory Clinics

• Primary Care initiatives

• Global budgets - % for seniors

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On October 28th, 2013 the NSM LHIN Board of Directors approved base

funding for seniors health as part of 2013/14 funding.

Two key areas of focus were identified for this funding:

1. Development of an integrated regional Seniors Health Program,

to start with a re-fresh of the 2009 NSM LHIN’s Vision for an

Integrated Regional Seniors Health Program document; and,

2. Stabilization of the NSM Geriatric Care Specialists (Geriatricians,

Geriatric Psychiatrists, Care of the Elderly Physicians).

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6

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Focus: FRAIL Seniors

• Present with:

o Multiple diseases with multiple drugs

o Multiple problem areas

o Slippery slope

• Can require a Medical/Psychiatric interface

• Increased importance in social networks

• Need for complex combination of medical and social services

requiring discharge planning support.

Dalziel, B. (2008). Can you Unfrail the Elderly? RGP Ontario GiiC Toolkit)

Definition:

“Specialized Geriatric Services” are defined as a comprehensive,

coordinated system of hospital and community-based health and

mental health services that diagnose, treat and rehabilitate frail seniors.

These services are provided by interdisciplinary teams with expertise in

care of the elderly and provided across the continuum of care. SGS is

inclusive of both Geriatric Medicine services and Geriatric Psychiatry

services.

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Clinical Services Model:

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Locally-Delivered SGS Services

Core Services: Available to all Seniors

Centrally-Delivered SGS Services

Frailty State

SGS Single Entry SystemSG

S P

rogr

am

Sen

iors

Hea

lth

Pro

gram

Roles & Functions:

• Leadership

• Clinical

Heart of the NSM SGS Program

• Education & Mentorship

• Advocacy

• Research & Ethics

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Strategic GoalsWhat will be focused on between 2014 – 2017

to achieve the strategic direction

Strategic Direction

What will be accomplished through this strategic

priority

Strategic Priority

Vision & Mission

VISION:Wellness,

Independence & Quality of Life in

Aging

MISSION:

Optimizing Health & Well-Being for Seniors-In-Need

Through an Integrated Regional

Program of Specialized

Geriatric Services

Improving Patient

Outcomes

Frail seniors across NSM will have access to

Specialized Geriatric Services that are

integrated , effective and collaborative.

1. Re-design existing NSM Specialized Geriatric Services to improve efficiency, equity and access.

2. Increase the knowledge of seniors and providers regarding NSM Specialized Geriatric Services.

3. Where possible, establish new Specialized Geriatric Services to address system gaps.

4. Improve partnerships between Geriatric Medicine services and Geriatric Psychiatry services.

5. Improve the care experience, including transitions.

Building Capacity

Frail seniors, their caregivers and their health care professionals will have

the knowledge and toolsthey need to optimize

health outcomes.

The Center of Excellence will:

1. Increase the number of health care professionals AND skillsets of health care professionals in the care of frail seniors.

2. Standardize and disseminate leading practices.

3. Increase education and mentorship opportunities for health care professionals, community providers and students.

4. Increase the self-management capacity of frail seniors and their caregivers.

Fostering System Change

The needs of frail seniors are reflected in health

system planning and policy change with the intent to

create a system that is affordable, sustainable and

accountable.

1. Sustain and build the pool of NSM Geriatric Care Specialists.

2. Establish the leadership structure for the NSM Specialized Geriatric Services Program (to include Persons With Lived Experience).

3. Partner with Care Connection Councils and Health Links to identify and, as appropriate, address needs and opportunities related to frail seniors.

4. Work locally and provincially to promote policy change to benefit frail seniors.

Quality Framework 2014-2017

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LHIN Action Plan (2015)

1. Establish the infrastructure for an integrated regional Seniors Health

Program, starting with Specialized Geriatric Services.

2. Support the development of a LHIN-wide basket of Specialized

Geriatric Services through redesign and integration.

3. Ensure alignment with, and completion of, key provincial initiatives

targeting frail seniors.

“Specialized Geriatric Services, including Behaviours” was

identified as a priority project of the NSM LHIN

from April 1st, 2015 – March 31st, 2018

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Establish infrastructure for

integrated regional

Seniors Health Program,

starting with SGS

Support development of a LHIN-wide

basket of SGS through redesign and

integration.

Alignment with /

completion of key

provincial initiatives

targeting frail seniors.

• Lead Agency • Seniors Health Project

Team • Leadership Team • Office Space • Regional Geriatric

Program of Ontario membership

• Physician Network

• SGS Clinical Design Report & Recommendations, inclusive of behaviours and a single entry

• System redesign, starting with

behaviours:o Behaviour Action Plan :

Complex Case Resolution Behaviour Success Agents Antipsychotic Use in LTC

o Enhanced BSO Funding o BSS Re-design

• Physician Recruitment • Education Community of Practice • Education Strategy • Health Information System Strategy

• Behaviour Supports Ontario

• Assess & Restore • Senior Friendly

Hospital Strategy • Dementia Strategy • Ministry/LHIN RGP/SGS

Review

Communication:2016 LHIN Seniors Communique SGS Newsletters NSM SGS Program Website

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Action Plan Progress: Highlights

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2016/17 Notable Numbers

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Indicator Volume

Clinical Design Committee Membership 36

Additional 2016/17 Behaviour Funding$750,000

3.5 FTE Temporary6.6 FTE Permanent

Complex Cases Reviewed 23+

Behaviour Success Agents (July 12-February 28)

159 cases1,514 direct/indirect

2,059 education

Physician Recruitment2

1 pending1 interested

Physician Network Membership 18

Key Messages

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• NSM SGS Program is in place, under the leadership of

Waypoint Centre for Mental Health Care and in partnership

with the NSM LHIN.

• Clinical Design Report and Education Strategy are complete

as guiding documents.

• Re-design is starting with the NSM Behaviour Support Service.

• Early work has been significant, focused on building the

program foundation.

• Partnerships and communication will be key to success going

forward.