Please send one original signed copy with schedules to: Attn: Anne Hagerman South East LHIN. 71 Adam Street. Belleville, ON, K8N5K3

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1 January 23, 2013 Mike Nicholson Regional Director Canadian National Institute for the Blind - Kingston District 826 Princess Street, Kingston ON K7L 1G3 71 Adam Street Belleville, ON K8N 5K3 Tel: Toll Free: Fax: , rue Adam Belleville, ON K8N 5K3 Téléphone : Sans frais : Télécopieur : Dear Mike Nicholson: Re: Multi-Sector Service Accountability Agreement When the South East Local Health Integration Network (the LHIN ) and the Canadian National Institute for the Blind - Kingston District (the HSP ) entered into a service accountability agreement for a three year term effective April 1, 2011 (the M-SAA ), there was insufficient information available to complete Schedules A, B and E for the third year of the term. The LHIN would now like to update the M-SAA to include the required financial, service activity and performance indicators for fiscal year to Schedules A, B and E. Subject to HSP s agreement, the M-SAA will be amended with effect April 1, 2013, by adding the Supplemental Schedules A, B and E (the Schedules ) that are attached to this letter, thereby incorporating the required financial, service activity and performance indicators for fiscal year To the extent that there are any conflicts between the current M-SAA and this amendment, the amendment will govern in respect of the Schedules. All other terms and conditions in the M-SAA will remain the same. Please indicate the HSP s acceptance of, and agreement to this amendment, by signing below and returning one original copy of this letter with schedules to Anne Hagerman, (the LHIN Contact ) by March 1 st, If you have any questions or concerns please contact Mike McClelland at mike.mcclelland@lhins.on.ca. Please send one original signed copy with schedules to: Attn: Anne Hagerman South East LHIN 71 Adam Street Belleville, ON, K8N5K3 Packages must be returned in person to the LHIN or via Courier by March 1 st, Canadian National Institute for the Blind - Kingston District re: Amendment of M-SAA for fiscal 13/14 1/2

2 The LHIN commends you and your team for your hard work and dedication during this process and we look forward to maintaining a strong working relationship with you. Sincerely, Paul Huras Chief Executive Officer encl. AGREED TO AND ACCEPTED BY: Canadian National Institute for the Blind - Kingston District By: Jane Beaumont, Board Chair, I have the authority to bind Canadian National Institute for the Blind - Kingston District And By: Mike Nicholson, Regional Director, I have the authority to bind Canadian National Institute for the Blind - Kingston District Canadian National Institute for the Blind - Kingston District re: Amendment of M-SAA for fiscal 13/14 2/2

3 Detailed Description of Services Healthcare Service Provider: Services Provided With LHIN Funding Service CSS In-Home and Community Services (CSS IH COM) * CSS IH COM Vision Impaired Care Services Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Area 1 Area 2 Area 3 Area 4 Area 5 Within LHIN Area 6 Area 7 Area 8 Area 9 Area 10 ALL Catchment Area Served ES SW WW HNHB CW Supplemental Schedule A1: Detailed Description of Services MH Other LHIN Areas x x TC CEN CE SE CH NS NE NW

4 Population and Geography Narratives Supplemental Schedule A2: Population and Geography Narratives Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Client Population CNIB is the first place Cndians turn when they are facing vision loss. Not everyone who comes to us is totally blind. In fact, nine out of ten people we assist have sone useful vision. We provide vital programs and servives, an extensive range of innovative consumer products to all people and one of the world's largest libraries for people with a print disabilitiy. Geography Served CNIB services are provided throughout the LHIN geographic area, in clients' homes, in CNIB offices or community facilities.

5 Summary of Revenue & Expenses Healthcare Service Provider: Supplemental Schedule B1: Budget Allocation Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 LHIN Program Revenue & Expenses Row # Account: Financial (F) Reference OHRS VERSION Budget REVENUE 12 F $421,910 Funding - Local Health Integrated Networks (LHIN) (Allocation) Funding - Provincial MOHLTC (Allocation) 13 F $0 Funding - MOHLTC Other funding envelopes 14 F $0 Funding - LHINs One Time 15 F $0 Funding MOHLTC One Time 16 F $0 Paymaster Flow Through 17 F $0 Service Recipient Revenue 18 F to $4,590 Subtotal Revenue LHIN/MOHLTC 19 Sum of Rows 12 to 18 $426,500 Recoveries from External/Internal Sources 20 F 120* $0 Donations 21 F 140* $0 22 F 130* to 190*, 110*, [excl. F 11006, 11008, 11010, $226,711 Other Funding Sources and Other Revenue 11012, 11014, 11019, to 11090, 131*, 140*, 141*, 151*] Subtotal Other Revenues 23 Sum of Rows 20 to 22 $226,711 TOTAL REVENUE- Fund Type 2 24 Sum of Rows 19 and 23 $653,211 EXPENSES Compensation Salaries and Wages (Worked + Benefit + Purchased) 27 F 31010, 31030, 31090, 35010, 35030, $410,675 Benefit Contributions 28 F to 31085, to $122,047 Employee Future Benefit Compensation 29 F 305* $0 Nurse Practitioner Remuneration 30 F 380* $0 Medical Staff Remuneration 31 F 390*, [excl. F 39092] $0 Sessional Fees 32 F $0 Service Costs Med/Surgical Supplies and Drugs 34 F 460*, 465*, 560*, 565* $0 Supplies and Sundry Expenses (excl. Med/Surg Supplies & 35 F 4*, 5*, 6*, [excl. F 460*, 465*, 560*, 565*, 69596, 69571, $81,052 Drugs) 72000, 62800, 45100, 69700] Community One Time Expense 36 F $0 Equipment Expenses 37 F 7*, [excl. F 750*, 780* ] $4, F 750*, 780* $0 Amortization on Major Equip and Software License and Fees Contracted Out Expense 39 F 8* $0 Buildings and Grounds Expenses 40 F 9*, [excl. F 950*] $15,047 Building Amortization 41 F 9* $20,178 TOTAL EXPENSES Fund Type 2 42 Sum of Rows 27 to 41 $653,211 NET SURPLUS/(DEFICIT) FROM OPERATIONS 43 Row 24 minus Row 42 $0 Amortization - Grants/Donations Revenue 44 F 131*, 141* & 151* $0 SURPLUS/DEFICIT Including Amortization of Grants/Donations 45 Sum of Rows 43 to 44 $0 FUND TYPE 3 - OTHER Total Revenue (Type 3) 47 F 1* $525,341 Total Expenses (Type 3) 48 F 3*, F 4*, F 5*, F 6*, F 7*, F 8*, F 9* $525,341 NET SURPLUS/(DEFICIT) FUND TYPE 3 49 Row 47 minus Row 48 $0 FUND TYPE 1 - HOSPITAL Total Revenue (Type 1) 51 F 1* $0 Total Expenses (Type 1) 52 F 3*, F 4*, F 5*, F 6*, F 7*, F 8*, F 9* $0 NET SURPLUS/(DEFICIT) FUND TYPE 1 53 Row 51 minus Row 52 $0 ALL FUND TYPES Total Revenue (All Funds) 55 Line 13 + line 32 + line 35 $1,178,552 Total Expenses (All Funds) 56 Line 28 + line 33 + line 36 $1,178,552 NET SURPLUS/(DEFICIT) ALL FUND TYPES 57 Row 55 minus Row 56 $0 Total Administration Expenses Allocated to the TPBEs Undistributed Accounting Centres 59 82* $0 Administration and Support Services * $111,046 Management Clinical Services $0 Medical Resources $0 Total Administrative & Undistributed Expenses (Included in fund type 2 expenses above) 63 Sum of Rows (included in Fund Type 2 expenses above $111,046

6 Activity Summary Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Supplemental Schedule B2: Service Category Budget Summary Service Category Budget OHRS Framework Level 3 Visits F2F, Tel.,In-House, Cont. Out Not Uniquely Identified Service Recipient Interactions Hours of Care In-House & Contracted Out Inpatient/Resid ent Days Individuals Served by Functional Centre Attendance Days Face-to- Face Group Sessions (# of group sessions- not individuals) Meal Delivered- Mental Health Combined Sessions Group Participant Attendances (Reg & Non- Reg) Service Provider Interactions (All Time Intervals) Service Provider Group Interactions (All Time Intervals) Total CSS In-Home and Community Services (CSS IH COM) , , Total Activity- LHIN Managed , ,

7 Core Indicators All Sectors Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Supplemental Schedule E1: CORE INDICATORS- All Sectors Accountability Indicators Target Performance Standard % Total Margin 0.00 >=0% Fund Type 2- Balanced Budget $0 0 Proportion of Budget Spent on Administration 17% < 20% Variance Forecast to Actual Expenditures 0% < 5% Variance Forecast to Actual Units of Service 0% < 5% Explanatory Indicators Cost per Unit Service (by Functional Centre) Cost per Individual Served (by program/service) > No negative variance is accepted for Total Margin > Fund Type 2- Balanced Budget: HSP's are required to submit a balanced budget.

8 Service Activity Indicators All Sectors Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Supplemental Schedule E2a: Service Category Detailed Indicators- All Sectors Full-time equivalents (FTE) Total Cost for Functional Centre Undistributed Accounting/Functional Centres 728, 729, 82 Total Cost for Functional Centre COM IH - Vision Impaired Care Services Full-time equivalents (FTE) Visits F2F, Tel.,In-House, Cont. Out Individuals Served by Functional Centre Total Cost for Functional Centre TOTAL FUNCTIONAL CENTRES & CHC Full-time equivalents (FTE) Visits F2F, Tel.,In-House, Cont. Out Individuals Served by Functional Centre Total Cost for Functional Centre OHRS Description & Functional Centre *FTE & Total Functional Centre Cost: These values are provided for information purposes only. They are not Accountability Indicators. Administration and Support Services 72 1 Target Performance Standard *1.21 N/A *$111,046 N/A *$20,178 N/A *7.30 N/A 8, , *$521,987 N/A *8.51 N/A 8, , *$653,211 N/A Service Category Detail Page 1 of 1

9 Sector Specific Indicators CSS Sector Healthcare Service Provider: Supplemental Schedule E2d : CSS Specific Indicators Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Accountability Indicators Target Performance Standard Percentage ALC Days 9.46% <10.41% Explanatory Indicators Repeat Unscheduled Emergency Visits within 30 days for Mental Health Conditions Repeat Unscheduled Emergency Visits within 30 days for Substance Abuse Conditions Number of Persons Waiting for Service (by functional centre)

10 LHIN Local Indicators LHIN Specific Supplimental Schedule E3: Local Indicators- All Sectors Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Name and Description Clinical Services Roadmap (CSR) Development of a regional, integrated system of health care that will improve access, quality of care and efficiency within the dollars currently available Clinical Services Roadmap: Coordinated Access South East LHIN Health System Local Obligations/Indicators Objective to be Measure achieved/demonstrated (How will we know the Data (desired outcome) outcome has been achieved?) Source/Reporting Community agencies will work collaboratively with hospitals, LTCH, primary care providers and the LHIN to implement approved CSR initiatives The CSR-CA team will identify a common Intake Assessment Form and a Standardized Referral Form. The HSP commits to implementing the common Intake Assessment Form and Standardized Referral Form. Milestones/deliverables within each initiatives implementation plan are achieved (detail will be provided to the HSPs when approved) Select deliverables identified in the CSR-CA work plan are achieved. These deliverables may include: Develop/adopt an inter- MHA agency referral form that utilizes common language Protocol Quarterly reports on CSR initiatives from the Clinical Work Teams. Monthly report on progress to be submitted to the CSR PMO from the CSR team. Progress target for each year of the agreement (as applicable) 2012/2013 Continue implementation and participate in Phase 2 as applicable 2013/2014 Participate in Phase 2 CSR as applicable. 2012/ % of HSP s in HPE utilizing a common Intake Assessment Form and a Standardized Referral Form 2013/ % of all HSP s utilizing a common Intake Assessment Form and a Standardized Referral Form.

11 LHIN Local Indicators LHIN Specific Supplimental Schedule E3: Local Indicators- All Sectors Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Name and Description Clinical Services Roadmap: Health Human Resources Clinical Services Roadmap: Emergency Department Objective to be achieved/demonstrated (desired outcome) The CSR-HHR team will finalize the core competencies, finalize the competency framework and identify appropriate training for the core competencies. 1) The CSR-ED team will develop a common consent form to facilitate sharing of patient sharing among relevant HSP s within the circle of care. 2) The CSR-ED team will engage with the SE LHIN to develop the model, budget and staffing plan for the transitional intensive client management program to provide smoother transitions for patients from the hospital to the community. South East LHIN Health System Local Obligations/Indicators Measure (How will we know the outcome has been achieved?) Deliverables identified in the CSR-HHR work plan are achieved. These deliverables may include: Develop a framework of competencies including a change management and sustainability plan for MH & A in the SE LHIN. Regulated professional competencies to be embedded in an appendix. 1) Select deliverables identified in the CSR-ED work plan are achieved. These deliverables may include: Develop a common consent/privacy form. 2) Complete business case developed by the CSR- ED team. Data Source/Reporting Protocol Monthly report on progress to be submitted to the CSR PMO from the CSR team. 1) Monthly report on progress to be submitted to the CSR PMO from the CSR team. 2) Submission of business case, budget and staffing plan to the SE LHIN. Progress target for each year of the agreement (as applicable) 2012/2013 CSR-HHR to finalize the core competencies and finalize the competency framework. 2013/2014 Develop and source training to facilitate competency training for HSP s. 1a) 2012/2013 Confirm the wording of the common consent form. 1b) 2013/ % of HSP s utilizing common consent form. 2) 2013/2014 SE LHIN will confirm the model, budget and staffing plan for a *transitional intensive client management program

12 LHIN Local Indicators LHIN Specific Supplimental Schedule E3: Local Indicators- All Sectors Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Name and Description Back Office integration Project- agencies from CSS, CMH&A, and CHC continue to implement LHIN Board approved BOIP initiatives including: Human Resources, Finance, Information Technology, and Purchasing. South East LHIN Health System Local Obligations/Indicators Objective to be Measure achieved/demonstrated (How will we know the Data (desired outcome) outcome has been achieved?) Source/Reporting The back office integration project is designed to maximize the amount of funding spent on direct patient care by the community in the South East through ensuring back office functions are as efficient, effective, and practical as possible. Providers will implement the LHIN board approved system level solutions (with the exception of those agencies who have received an exemption from the LHIN board. Common policies and purchasing arrangements for the purchasing function. Regional HR Training model implemented and focusing initially on legislative training requirements. Regional Knowledge Management solution for shared model of HR policies Implementation of Host/customer finance model. Development and implementation of shared benefits model. Development and implementation of shared IT management model. Detailed project plans are currently available through the BOIP PMO and detailed implementation plans will be developed by BOIP Leads by end of Protocol Reporting through BOIP PMO on Quarterly basis. Progress target for each year of the agreement (as applicable) 2011/12 *Implemented HR Training, Purchasing, Finance and Knowledge Management regional models 2011/13 *Implemented HR Shared Benefits and IT model *Unless an exemption has been approved by the LHIN Board

13 LHIN Local Indicators LHIN Specific Supplimental Schedule E3: Local Indicators- All Sectors Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Name and Description Reduction of ER Demand reducing the number of ER visits that could have been avoided or managed elsewhere to enable ER clinicians to focus on patients with urgent or emergent needs and reduce the associated wait times. South East LHIN Health System Local Obligations/Indicators Objective to be Measure achieved/demonstrated (desired (How will we know the outcome has outcome) been achieved?) To reduce residents presenting for care to hospital through ER. Examples include: Family/patient no longer coping at home Lack of access to support within the community sector Deterioration of patients with chronic conditions requiring hospitalization including those patients with Mental Health or Addictions needs. To improve the access to ER care for those clients who require urgent and emergent care. Improve the quality or ER care by allowing ER resources to be focused on urgent and emergent care in a timely manner 1. Rate of unscheduled ER visits per quarter per 1,000 population. 2. ER Wait Times for non-admitted patients (90 th percentile) Data Source/Reporting Protocol Data provided monthly by MOHLTC Progress target for each year of the agreement (as applicable) TDB 2. a) 6.6 Hrs b) 3.9 Hrs TDB 2. a) 6.6 Hrs b) 3.9 Hrs TDB 2. a) 6.6 Hrs b) 3.9 Hrs

14 LHIN Local Indicators LHIN Specific Supplimental Schedule E3: Local Indicators- All Sectors Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Name and Description Excellent Care for All Act- All HSPs will eventually have to meet the requirements of the Excellent Care for All Act, Objective to be achieved/demonstrated (desired outcome) The Act requires the creation of Quality Committees, annually prepared and publically available Quality Improvement Plans (QIPs), the implementation of patent, client and caregiver satisfaction surveys, as well as employee and care provider surveys; a patient relations process as well as a patient declaration of values for all HSPs; starting with hospitals. Quality is a driver of health system efficiency. The LHIN wishes to accelerate portions of ECFAA beyond the hospital sector. To this end, HSPs would review and commence planning and implementation of short form Quality Improvement Plans (QIPs) for their organizations. This approach will increase understanding and capacity of QIP development, the inter-relationship of quality among providers, and expedite provincial implementation South East LHIN Health System Local Obligations/Indicators Measure (How will we know the outcome has been achieved?) As referenced in the Act the LHIN requires HSPs to submit a Short Form QIP to the LHIN as a local performance obligation as described in each year of the SAA. HSPs will report back to the LHIN annually on the achievement of targets embedded in their submitted QIPs; report backs will include remediation plans for any targets not met. Care provider surveys may be conducted to provide insight/feedback into how well agencies are collaborating in the joint care of clients. *Note: there will be no penalties applied until HSPs are mandated provincially to prepare and submit QIPs to the Ontario Health Quality Council Data Source/Reporting Protocol HSP submission and self-reporting Minimum core indicators: HAI (CDI, hand hygiene) ALC Patient satisfaction Provider surveys (pending) Progress target for each year of the agreement (as applicable) CCAC (with hospitals) all shared indicators CSS, CMHA & CHCs (indicators noted- unless provincial standards are in force) CCAC (with hospitals) all shared indicators

15 LHIN Local Indicators LHIN Specific Supplimental Schedule E3: Local Indicators- All Sectors Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Name and Description ehealth/information Technology Compliance- To ensure consistent and standardized ehealth/it solutions across the LHIN Objective to be achieved/demonst rated (desired outcome) The HSP agrees to comply with any standard related to architecture, technology, privacy and security set for health service providers by the MOHLTC, ehealth Ontario, or the LHIN with the timeframes set by the MOHLTC or the LHIN. South East LHIN Health System Local Obligations/Indicators Measure (How will we know the Data Source/Reporting outcome has been achieved?) Protocol Development and implementation of the Shared Regional IT Management model, as described in the BOIP. Components of which are: 1. Develop a Model for Strategic IT Planning. 2. Develop a Disaster Recovery Standard/Approach 3. Develop a Model for Central Support of the InterRAI CHA 4. Shared IT Operations 5. Standard policies and procedures 6. Shared Connectivity and Access 7. Collaborate to provide equitable IT training for all agencies 8. Simple, affordable standard IT procurement. Regular report on progress from BOIP IT working group HSP to provide timely identification of potential IT infrastructure or software conflicts as applicable. Progress target for each year of the agreement (as applicable) Development of Shared Regional IT Management model Implemented shared regional IT management model Continue to explore opportunities to expand as they arise.

16 LHIN Local Indicators LHIN Specific Supplimental Schedule E3: Local Indicators- All Sectors Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Name and Description Integration Activities Reporting- all integration activity follows LHSIA protocol and is publicly identified South East LHIN Health System Local Obligations/Indicators Measure (How will we know the outcome has been achieved?) Objective to be achieved/demonstrated (desired outcome) The Local Health System Integration Act, 2006 requires the LHIN and health service providers to identify and report integration opportunities. Health service providers may voluntarily integrate services. HSPs must advise the LHIN prior to proceeding and follow the LHIN s process for this, as described on the LHIN website. Health service providers will submit identified integration opportunities semiannually, as described on the LHIN website. HSPs will follow the process for voluntary integration activities set out by the LHIN. Data Source/Reporting Protocol Compliance with statute Submission of opportunities semi-annually Appropriate use of LHIN process for voluntary integration activities. Progress target for each year of the agreement (as applicable) Full compliance Full compliance Full compliance

17 LHIN Local Indicators LHIN Specific Supplimental Schedule E3: Local Indicators- CSS Sector Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 Name and Description Consistent application of InterRAI CHA by CSS providers South East LHIN Health System Local Obligations/Indicators CSS SECTOR SPECIFIC Objective to be Measure Progress target for each achieved/demonstrated (How will we know the Data Source Reporting year of the agreement (as (desired outcome) outcome has been Protocol applicable) Evidence of the utilization of the InterRAI CHA tool to assess client service needs through a standard approach. Availability of assessment data from the CSS sector to support evidence based decision making for the sector. achieved?) Quarterly submission of assessment data. CSS agencies submit quarterly anonymized InterRAI CHA assessment data to the LHIN % reporting compliance by all CSS organizations using the InterRAI CHA.

18 LHIN Local Indicators LHIN Specific Supplimental Schedule E3: Local Indicators- French Language Services Healthcare Service Provider: Canadian National Institute for the Blind Ontario Division, Kingston and Belleville- Facility # 4218 South East LHIN Health System Local Obligations/Indicators FRENCH LANGUAGE SERVICES- Designated Agencies Name and Description Objective to be achieved/demonstrated (desired outcome) Measure (How will we know the outcome has been Data Source Reporting Protocol Progress target for each year of the agreement French Language Services (FLS) Identified organizations of Kingston Requirements - As the HSP is identified by the South East LHIN to provide services in both Official Languages (English and French) in a designated area under the French Language Services Act, and therefore must implement the designation work plan in order to work towards the intention of the designation under the Act. The HSP will actively participate in activities designed to support the implementation of their FLS plan and designation work plan, including working with the Réseau and the LHIN. The HSP will: - Set up a FLS working group with representation from the Réseau (Q1), that will actively meet at least three times a year; - Set objectives and timelines in the FLS work plan (Q2). achieved?) Annually report to the LHIN an update on their progress with respect to their FLS plan. a) in a format provided by the LHIN (Q4), or b) WERS/SRI (on hold pending provincial review). (as applicable) 2013/14: March 31st 2014

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