MSAA AMENDING AGREEMENT. THIS AMENDING AGREEMENT (the Agreement ) is made as of the 1 st day of July, 2018

Transcription

1 MSAA AMENDING AGREEMENT THIS AMENDING AGREEMENT (the Agreement ) is made as of the 1 st day of July, 2018 B E T W E E N: AND CHAMPLAIN HEALTH INTEGRATION NETWORK (the LHIN ) VHA HEALTH AND HOME SUPPORT (the HSP ) WHEREAS the LHIN and the HSP (together the Parties ) entered into a multi-sector service accountability agreement that took effect April 1, 2018 (the MSAA); AND WHEREAS the Parties have agreed to continue to work to finalize new schedules for the Funding Year to replace the Schedules; AND WHEREAS the Parties wish to make certain changes to the Schedules; NOW THEREFORE in consideration of mutual promises and agreements contained in this Agreement and other good and valuable consideration, the Parties agree as follows: 1.0 Definitions. Except as otherwise defined in this Agreement, all terms shall have the meaning ascribed to them in the MSAA. 2.0 Amendments. 2.1 Agreed Amendments. The MSAA is amended as set out in this Article Schedule E3a Amended. Not Applicable 2.3 Schedules under MSAA. Immediately upon the MSAA coming into effect, the Schedules, as defined in the MSAA, will be the Schedules for the purposes of, and as defined in, the MSAA. 2.4 Schedule Definition Amended. The definition of Schedule is amended to include the attached Supplementary Schedule AA. 2.5 New Schedules. Upon agreement of the Parties, the Schedules shall replace the Schedules for purposes of the MSAA. 3.0 Effective Date. The amendments set out in Article 2 shall take effect on July 1, All other terms of the MSAA shall remain in full force and effect. MSAA Amending Agreement MSAA, Schedules Page 1

2 4.0 Governing Law. This Agreement and the rights, obligations and relations of the Parties will be governed by and construed in accordance with the laws of the Province of Ontario and the federal laws of Canada applicable therein. 5.0 Counterparts. This Agreement may be executed in any number of counterparts, each of which will be deemed an original, but all of which together will constitute one and the same instrument. 6.0 Entire Agreement. This Agreement constitutes the entire agreement between the Parties with respect to the subject matter contained in this Agreement and supersedes all prior oral or written representations and agreements. IN WITNESS WHEREOF the Parties have executed this Agreement on the dates set out below. CHAMPLAIN LOCAL HEALTH INTEGRATION NETWORK By: Jean-Pierre Boisclair Jean-Pierre Boisclair, Chair And by: Chantale LeClerc Chantale LeClerc, CEO August 17, 2018 Date August 7, 2018 Date VHA HEALTH AND HOME SUPPORT By: Steve Cutler June 29, 2018 Steve Cutler, Chair Date And by: Valerie Bishop-de Young June 29, 2018 Valerie Bishop-de Young, Date Executive Director MSAA Amending Agreement MSAA, Schedules Page 2

3 MULTI-SECTOR SERVICE ACCOUNTABILITY AGREEMENT FOR SUPPLEMENTARY SCHEDULE AA 1. Despite any other provision of this Agreement, the Schedules are effective until August 31, 2018 and no longer, unless otherwise agreed to in writing by the parties. MSAA Amending Agreement MSAA, Schedules Page 3

4 4200 Labelle Street, Suite 100 Ottawa, ON K1J 1J8 Tel Fax Toll Free , rue Labelle, bureau 100 Ottawa, ON K1J 1J8 Téléphone : Télécopieur : Sans frais : September 6, 2018 Ms. Valerie Bishop-de Young VHA Health and Home Support 250 City Centre Ave Suit 700 Ottawa, K1R 6K7 Dear Ms. Bishop-de Young, Re: Confirmation of New MSAA Schedules Further to section 2.4 of the M-SAA Amending Agreement between the Champlain Local Health Integration Network (the LHIN ) and VHA Health and Home Support (the HSP ), this is to confirm that, effective April 1, 2018, the attached new schedules replace the Schedules as defined in the Multi-Sector Service Accountability Agreement July 1, 2018 to August 31, 2018 between the LHIN and the HSP. Please indicate the HSP s acknowledgment of, and agreement with, the foregoing by signing below and returning one copy of this letter to CH.AccountabilityTeam@lhins.on.ca by September 10, If you have any questions or concerns please contact Colleen Taylor, Senior Accountability Specialist at Colleen.Taylor@lhins.on.ca or (613) Sincerely, Chantale LeClerc Chief Executive Officer

5 ACKNOWLEGED AND AGREED TO BY: VHA Health and Home Support Steve Cutler September 10, 2018 Steve Cutler, Chair Date And By: Valerie Bishop de-young September 10, 2018 Valerie Bishop de-young, Executive Director Date CHAMPLAIN LOCAL HEALTH INTEGRATION NETWORK By: Jean-Pierre Boisclair Jean-Pierre Boisclair, Chair November 7, 2018 Date And By: Chantale LeClerc November 2, 2018 Chantale LeClerc, CEO Date

6 Schedule B1: Total LHIN Funding LHIN Program Revenue & Expenses Row # Account: Financial (F) Reference OHRS VERSION 10.0 Plan Target REVENUE LHIN Global Base Allocation 1 F $10,258,358 HBAM Funding (CCAC only) 2 F $0 Quality-Based Procedures (CCAC only) 3 F $0 MOHLTC Base Allocation 4 F $0 MOHLTC Other funding envelopes 5 F $0 LHIN One Time 6 F $0 MOHLTC One Time 7 F $0 Paymaster Flow Through 8 F $0 Service Recipient Revenue 9 F to $279,288 Subtotal Revenue LHIN/MOHLTC 10 Sum of Rows 1 to 9 $10,537,646 Recoveries from External/Internal Sources 11 F 120* $0 Donations 12 F 140* $0 Other Funding Sources & Other Revenue 13 F 130* to 190*, 110*, [excl. F 11006, 11008, 11010, 11012, 11014, 11019, $65, to 11090, 131*, 140*, 141*, 151*] Subtotal Other Revenues 14 Sum of Rows 11 to 13 $65,688 TOTAL REVENUE FUND TYPE 2 15 Sum of Rows 10 and 14 $10,603,334 EXPENSES Compensation Salaries (Worked hours + Benefit hours cost) 17 F 31010, 31030, 31090, 35010, 35030, $7,590,425 Benefit Contributions 18 F to 31085, to $1,925,918 Employee Future Benefit Compensation 19 F 305* $0 Physician Compensation 20 F 390* $0 Physician Assistant Compensation 21 F 390* $0 Nurse Practitioner Compensation 22 F 380* $0 Physiotherapist Compensation (Row 128) 23 F 350* $0 Chiropractor Compensation (Row 129) 24 F 390* $0 All Other Medical Staff Compensation 25 F 390*, [excl. F 39092] $0 Sessional Fees 26 F $0 Service Costs Med/Surgical Supplies & Drugs 27 F 460*, 465*, 560*, 565* $0 Supplies & Sundry Expenses 28 F 4*, 5*, 6*, [excl. F 460*, 465*, 560*, 565*, 69596, 69571, 72000, 62800, 45100, 69700] $655,319 Community One Time Expense 29 F $0 Equipment Expenses 30 F 7*, [excl. F 750*, 780* ] $20,000 Amortization on Major Equip, Software License & Fees 31 F 750*, 780* $0 Contracted Out Expense 32 F 8* $0 Buildings & Grounds Expenses 33 F 9*, [excl. F 950*] $411,672 Building Amortization 34 F 9* $0 TOTAL EXPENSES FUND TYPE 2 35 Sum of Rows 17 to 34 $10,603,334 NET SURPLUS/(DEFICIT) FROM OPERATIONS 36 Row 15 minus Row 35 $0 Amortization - Grants/Donations Revenue 37 F 131*, 141* & 151* $0 SURPLUS/DEFICIT Incl. Amortization of Grants/Donations 38 Sum of Rows 36 to 37 $0 FUND TYPE 3 - OTHER Total Revenue (Type 3) 39 F 1* $1,610,988 Total Expenses (Type 3) 40 F 3*, F 4*, F 5*, F 6*, F 7*, F 8*, F 9* $1,537,002 NET SURPLUS/(DEFICIT) FUND TYPE 3 41 Row 39 minus Row 40 $73,986 FUND TYPE 1 - HOSPITAL Total Revenue (Type 1) 42 F 1* $0 Total Expenses (Type 1) 43 F 3*, F 4*, F 5*, F 6*, F 7*, F 8*, F 9* $0 NET SURPLUS/(DEFICIT) FUND TYPE 1 44 Row 42 minus Row 43 $73,986 ALL FUND TYPES Total Revenue (All Funds) 45 Line 15 + line 39 + line 42 $12,214,322 Total Expenses (All Funds) 46 Line 16 + line 40 + line 43 $12,140,336 NET SURPLUS/(DEFICIT) ALL FUND TYPES 47 Row 45 minus Row 46 $73,986 Total Admin Expenses Allocated to the TPBEs Undistributed Accounting Centres 48 82* $0 Plant Operations * $411,672 Volunteer Services * $0 Information Systems Support * $50,000 General Administration * $795,992 Other Administrative Expenses * $0 Admin & Support Services * $1,257,664 Management Clinical Services $0 Medical Resources $0 Total Admin & Undistributed Expenses 57 Sum of Rows 48, 54, (included in Fund Type 2 expenses above) $1,257,664

7 Schedule B2: Clinical Activity- Summary Service Category Budget OHRS Framework Level 3 Full-time equivalents (FTE) Visits F2F, Tel.,In- House, Cont. Out Not Uniquely Identified Service Recipient Interactions Hours of Care In- House & Contracted Out Inpatient/Resident Days Individuals Served by Functional Centre Attendance Days Group Sessions (# Meal Deliveredof group sessions- Combined not individuals) Group Participant Attendances (Reg & Non-Reg) Service Provider Interactions Service Provider Group Interactions Mental Health Sessions CSS In-Home and Community Services (CSS IH COM) * ,640 27,

8 Schedule C: Reports Community Support Services

9 Schedule C: Reports Community Support Services

10 Schedule D: Directives, Guidelines and Policies Community Support Services

11 Schedule E1: Core Indicators Performance Indicators Target Performance Standard *Balanced Budget - Fund Type 2 $0 >=0 Proportion of Budget Spent on Administration 11.9% <=14.2% **Percentage Total Margin 0.0% >= 0% Percentage of Alternate Level of Care (ALC) days (closed cases) Variance Forecast to Actual Expenditures 0.0% < 5% Variance Forecast to Actual Units of Service 0.0% < 5% Service Activity by Functional Centre Number of Individuals Served Refer to Schedule E2a Refer to Schedule E2a - - Alternate Level of Care (ALC) Rate 12.7% <13.97% Explanatory Indicators Cost per Unit Service (by Functional Centre) Cost per Individual Served (by Program/Service/Functional Centre) Client Experience Percentage of Alternate Level of Care (ALC) days (closed cases) * Balanced Budget Fund Type 2: HSP's are required to submit a balanced budget ** No negative variance is accepted for Total Margin

12 Schedule E2a: Clinical Activity- Detail Administration and Support Services 72 1* Target Performance Standard Full-time equivalents (FTE) 72 1* 3.50 n/a Total Cost for Functional Centre 72 1* $1,257,664 n/a CSS IH - Personal Support/Independence Training Full-time equivalents (FTE) n/a Hours of Care , Individuals Served by Functional Centre Total Cost for Functional Centre $4,602,662 n/a CSS IH - Respite Full-time equivalents (FTE) n/a Hours of Care , Individuals Served by Functional Centre Total Cost for Functional Centre $949,500 n/a CSS IH - Assisted Living Services Full-time equivalents (FTE) n/a Inpatient/Resident Days , Individuals Served by Functional Centre Total Cost for Functional Centre $3,793,508 n/a ACTIVITY SUMMARY OHRS Description & Functional Centre * These values are provided for information purposes only. They are not Accountability Indicators. Ful Total Full-Time Equivalents for all F/C n/a Ho Total Hours of Care for all F/C 138, InpTotal Inpatient/Resident Days for all F/C 27, IndTotal Individuals Served by Functional Centre for all F/C Tot Total Cost for All F/C 10,603,334 n/a

13 Schedule E2d: CSS Sector Specific Indicators Performance Indicators Target Performance Standard No Performance Indicators - - Explanatory Indicators # Persons waiting for service (by functional centre)

14 Schedule E3a Local: All Indigenous Cultural Awareness: The Health Service Provider will report on the activities it has undertaken during the fiscal year to increase the indigenous cultural awareness and sensitivity of its staff, physicians and volunteers throughout the organization. This supports the goal of improving access to health services and health outcomes for indigenous people. The Indigenous Cultural Awareness Report, using a template to be provided by the LHIN, is due to the LHIN by April 30, 2019 and should be submitted using the subject line: Indigenous Cultural Awareness Report to ch.accountabilityteam@lhins.on.ca. HSPs that have multiple accountability agreements with the LHIN should provide one aggregated report for the corporation. Executive Succession: The Health Service Provider must inform the LHIN prior to undertaking a recruitment process or appointment for a CEO or Executive Director. Health Links Partners: The Health Service Provider, in collaboration with the Health Link Lead and other partners, will contribute to the scaling and sustainability of Health Links care coordination with patients/clients with complex needs, including the identification of clients, participation on patient care teams and as appropriate, delivery of coordinated care to achieve the target number of coordinated care plans. The HSP will ensure awareness within its organization of the Health Links approach, the desired patient and system outcomes and its contribution to advancing this critical work. The HSP is aware that the specific system-metrics that are being monitored and reported include: - The percentage of 30 day readmissions to hospitals within the sub-region; - The percentage of acute care patients who have had a follow-up with a physician within 7 days of discharge within the sub-region; and - The number of avoidable ED visits for identified complex patients with conditions best managed elsewhere within the sub-region. In , the HSP will work in collaboration with the LHIN, the Health Links Leads and primary care organizations (as appropriate) to support reporting for the following information: - Patient experience metrics; - The number and percentage of complex patients with regular and timely access to a primary care provider. - The average time patients waited from referral (for CCP) to initial assessment; and - The number of sectors and organizations involved in identifying and referring individuals who might benefit from a coordinated care plan. For Specific-HSPs providing care coordination: The HSP will meet its commitments for: - Care coordination capacity as agreed to with the sub-regional Health Link Lead organization Capacity Plan and - Completed Coordinated Care Plans (CCPs) by March 31, The number of completed Coordinated Care Plan committed will be outlined in an amendment to this agreement in Q , if applicable. The HSP will provide requested information to the respective Health Link Lead to support timely and accurate reporting. Sub-region Planning: The Champlain LHIN has established five sub-regions in order to improve patient and client health outcomes through population health planning and integrated service delivery. HSPS are expected to collaborate in the development of sub-region planning, and to contribute to more coordinated care for sub-regional populations across the continuum of primary, home, community, and long-term care and to improve transitions from hospital to community care. This will require close collaboration and partnership with primary care providers in each sub-region in meeting the needs of their patients.

15 Schedule E3d Local: CSS Local Indicators Community Support Services Strategic Plan and Information Technology Initiatives: The Champlain Community Support Strategic Plan was approved in fiscal by the LHIN and the associated information technology projects were prioritized in August 2015 by the Champlain Community Services Network. The Health Service Provider will collaborate in the implementation of this plan and the relevant projects. The projects which the Health Service Provider will support include, but are not limited to, 1. Common Intake Standards for Community Health Sector 2. Common Consent 3. Reducing Duplicate Assessments Regionally (and compliance with provincial intent) 4. Common Discharge Policy and Procedure 5. Comprehensive Client Electronic Referral 6. Use of the Coordinated Care Plan for Health Links patients as appropriate 7. Wait List Management Process and Framework 8. Training and Education Strategy 9. Providing access to client and service usage data for LHIN and sub-region service planning 10. Renewal of the Champlain LHIN s Digital Health Strategy Critical Identifier Data Elements Obligation: The HSP will collect personal identifier information including OHIP number, 6-digit postal code, date of birth, full address, and full name, for each individual served within community support services programs at their organization. This consistent collection will support regional planning and evaluation exercises, and enable linkages between data sets across various technology systems. Collection of these critical data elements will improve coordination, efficiency, and consistency in service delivery to clients. Sub-acute Care Plan Implementation: The Health Service Provider will maintain an awareness of the Champlain LHIN Sub-acute Care Plan and participate in implementation as requested by the LHIN. The HSP s sub-acute care volume, performance, and associated funding will be adjusted in accordance with, and subject to the approval, of the regional subacute care implementation plan.

16 Schedule F: Project Funding Project Funding Agreement Template Note: This project template is intended to be used to fund one-off projects or for the provision of services not ordinarily provided by the HSP. Whether or not the HSP provides the services directly or subcontracts the provision of the services to another provider, the HSP remains accountable for the funding that is provided by the LHIN. THIS PROJECT FUNDING AGREEMENT ( PFA ) is effective as of [insert date] (the Effective Date ) between: XXX LOCAL HEALTH INTEGRATION NETWORK (the LHIN ) - and - [Legal Name of the Health Service Provider] (the HSP ) WHEREAS the LHIN and the HSP entered into a service accountability agreement dated [insert date] (the SAA ) for the provision of Services and now wish to set out the terms of pursuant to which the LHIN will fund the HSP for [insert brief description of project] (the Project ); NOW THEREFORE in consideration of their respective agreements set out below and subject to the terms of the SAA, the parties covenant and agree as follows: 1.0 Definitions. Unless otherwise specified in this PFA, capitalized words and phrases shall have the meaning set out in the SAA. When used in this PFA, the following words and phrases have the following meanings: Project Funding means the funding for the Services; Services mean the services described in Appendix A to this PFA; and Term means the period of time from the Effective Date up to and including [insert project end date]. 2.0 Relationship between the SAA and this PFA. This PFA is made subject to and hereby incorporates the terms of the SAA. On execution this PFA will be appended to the SAA as a Schedule. 3.0 The Services. The HSP agrees to provide the Services on the terms and conditions of this PFA including all of its Appendices and schedules. 4.0 Rates and Payment Process. Subject to the SAA, the Project Funding for the provision of the Services shall be as specified in Appendix A to this PFA.

17 Schedule F: Project Funding Project Funding Agreement Template 5.0 Representatives for PFA. (a) The HSP s Representative for purposes of this PFA shall be [insert name, telephone number, fax number and address.] The HSP agrees that the HSP s Representative has authority to legally bind the HSP. (b) The LHIN s Representative for purposes of this PFA shall be: [insert name, telephone number, fax number and address.] 6.0 Additional Terms and Conditions. The following additional terms and conditions are applicable to this PFA. (a) Notwithstanding any other provision in the SAA or this PFA, in the event the SAA is terminated or expires prior to the expiration or termination of this PFA, this PFA shall continue until it expires or is terminated in accordance with its terms. (b) [insert any additional terms and conditions that are applicable to the Project] IN WITNESS WHEREOF the parties hereto have executed this PFA as of the date first above written. [insert name of HSP] By: [insert name and title] [XX] Local Health Integration Network By: [insert name and title]

18 Schedule F: Project Funding Project Funding Agreement Template APPENDIX A: SERVICES 1. DESCRIPTION OF PROJECT 2. DESCRIPTION OF SERVICES 3. OUT OF SCOPE 4. DUE DATES 5. PERFORMANCE TARGETS 6. REPORTING 7. PROJECT ASSUMPTIONS 8. PROJECT FUNDING 8.1The Project Funding for completion of this PFA is as follows: 8.2 Regardless of any other provision of this PFA, the Project Funding payable for the completion of the Services under this PFA is onetime finding and is not to exceed [X].

19 Schedule G: Declaration of Compliance DECLARATION OF COMPLIANCE Issued pursuant to the M-SAA effective April 1, 2018 To: The Board of Directors of the [insert name of LHIN] Local Health Integration Network (the LHIN ). Attn: Board Chair. From: Date: The Board of Directors (the Board ) of the [insert name of HSP] (the HSP ) [insert date] Re: April 1, 2018 March 31, 2019 (the Applicable Period ) Unless otherwise defined in this declaration, capitalized terms have the same meaning as set out in the M-SAA between the LHIN and the HSP effective April 1, The Board has authorized me, by resolution dated [insert date], to declare to you as follows: After making inquiries of the [insert name and position of person responsible for managing the HSP on a day to day basis, e.g. the Chief Executive Office or the Executive Director] and other appropriate officers of the HSP and subject to any exceptions identified on Appendix 1 to this Declaration of Compliance, to the best of the Board s knowledge and belief, the HSP has fulfilled, its obligations under the service accountability agreement (the M-SAA ) in effect during the Applicable Period. Without limiting the generality of the foregoing, the HSP has complied with: (i) Article 4.8 of the M-SAA concerning applicable procurement practices; (ii) The Local Health System Integration Act, 2006; and (iii) The Public Sector Compensation Restraint to Protect Public Services Act, [insert name of Chair], [insert title]