Welcome to the Mississauga Halton LHIN Governance to Governance Session Have something to eat, introduce yourselves to others at your table and please take the time to read the background for the Facilitated Consultation. Thank you
Mississauga Halton LHIN Governance to Governance Session with Dr. Samir Sinha June 6, 2013
Agenda Agenda Item Lead Time Welcome and Introductions Ron Haines 5 minutes Vice Chair MH LHIN Board of Directors Introduction of Community Governance Jeannie Collins-Ardern 10 minutes Consultation Group Introduction of Dr. Samir Sinha Bill MacLeod 5 minutes Chief Executive Officer MH LHIN Dr. Samir Sinha 40 minutes Presentation on “Living Longer, Living Well” Provincial Lead Ontario’s Seniors Strategy Break 10 minutes Facilitated Consultation Bill MacLeod / Angela Jacobs 30 minutes Panel: Dr. Samir Sinha 20 minutes • Interactive Consultation Debrief Judy Bowyer Bill MacLeod Liane Fernandes Closing Remarks Ron Haines 5 minutes Vice Chair 3
Welcome Ron Haines Vice Chair Board of Directors Mississauga Halton LHIN 4
Introduction of Community Governance Consultation Group Jeannie Collins-Ardern Co-Chair Community Governance Consultation Group 5
Members of Community Governance Consultation Group Name Organization Jeannie Collins-Ardern (Co-Chair) Links2Care Ron Haines (Co-Chair) MH LHIN Board Peter Garrod Acclaim Health Naz Husain BALANCE Blind Adults Learning About Normal Community Environment Kimblain Kelly Canadian Mental Health Association – Halton Region Branch (CMHA – HRB) Robert Stansfield CCAC Cheryl Englander Heart House Hospice Yves Belanger Nucleus Independent Living Karen Kwan Anderson Peel Addiction Assessment and Referral Centre (PAARC) Carol Williams Peel Senior Link David Lukey Red Cross Judith Robinson Seniors Life Enhancement Centres Garth Brown Support and Housing Halton Irwin Lynch The Canadian Hearing Society Jackie Conant MH LHIN Board Shelagh Maloney MH LHIN Board Jason Wadden MH LHIN Board Bill MacLeod MH LHIN CEO Angela Jacobs MH LHIN Staff 6
Introduction of Dr. Samir Sinha Provincial Lead Ontario’s Seniors Strategy Bill MacLeod CEO Mississauga Halton LHIN 7
Ontario’s Seniors Strategy: Where We Stand. Where We Need to Go… Dr. Samir K. Sinha MD, DPhil, FRCPC Provincial Lead, Ontario’s Seniors Strategy Director of Geriatrics Mount Sinai and the University Health Network Hospitals Assistant Professor of Medicine University of Toronto and the Johns Hopkins University School of Medicine MH LHIN Governance to Governance Event 06 June, 2013
Establishing our Context 14.6% of Ontarians are 65 and older, yet account for nearly half of all health and social care spending (Census, 2011). Ontario’s older population is set to double over the next twenty years, while its 85 and older population is set to quadruple (Sinha, Healthcare Papers 2011). Ontario’s ageing population represents both a challenge and an opportunity.
Ontario Inpatient Hospitalizations Age Discharges Total LOS Days ALOS Population Total 945,089 6,075,270 6.4 Population 65+ 370,039 (39%) 3,516,006 (58%) 9.8 7.3 65-69 6.9% 7.9% 70-74 7.7% 9.8% 8.2 9.4 75-79 8.5% 12.5% 80-84 7.9% 13% 10.5 85-89 5.3% 9.4% 11.4 90+ 2.8% 5.3% 12.2 Canadian Institutes for Health Information (CIHI)
Ageing and Hospital Utilization in Mississauga Halton LHIN Number Age <65 Seniors 65 + % Seniors 75+ 88% Total Population 1,108,355 12% 45% 81% Emergency Room Visits 339,398 19% 59% 37% Acute Hospitalizations 69,235 63% 37% w/ Alternate Level of Care Days 44,006 16% 84% 64% 66% w/ Circulatory Diseases 8,420 37% 63% w/ Respiratory Diseases 5,418 48% 52% 73% 50% w/ Cancer 5,467 58% 42% w/ Injuries 4,871 55% 45% 71% w/ Mental Health 1,150 63% 37% 79% Inpatient Rehabilitation 2,780 21% 79% 75% Fiscal Year 2011/12
Ageing and Hospital Utilization in North East LHIN Number Age <65 Seniors 65 + % Seniors 75+ Total Population 551,042 82% 18% 45% Emergency Room Visits 443,469 79% 21% 53% Acute Hospitalizations 65,691 57% 43% 60% w/ Alternate Level of Care Days 3,888 16% 84% 78% w/ Circulatory Diseases 9,694 35% 65% 61% w/ Respiratory Diseases 5,218 45% 55% 64% w/ Cancer 3,131 38% 62% 53% w/ Injuries 5,220 57% 43% 65% w/ Mental Health 2,037 71% 29% 66% Inpatient Rehabilitation 907 29% 71% 69% North East LHIN
Ageing and Hospital Utilization in the 70+ Inconsistently High Users Consistently High Users 4.8% 6.8% 42.6% 24.6% Consistently Low Users No Hospital Episodes Only a small proportion of older adults are consistently extensive users of hospital services (Wolinsky, 1995)
What Defines our Highest Users? Polymorbidity Functional Impairments Social Frailty
The Top 5 System Barriers to Integrating Care for Older Adults Issue 1: We Do Little to Empower Older Adults and Caregivers with the Information They Need to Navigate the System. Issue 2: We Don’t Require Any Current or Future Health or Social Care Professional to Learn About Care of the Elderly. Issue 3: We Don’t Talk to Each Other Well Within and Between Sectors and Professions. Issue 4: We Work in Silos and Not as a System. Issue 5: We Plan for Today and Not for Tomorrow with Regards to Understanding the Mix of Services we Should Invest In to Support Sustainability.
Why Should this Matter? According to ICES, in Ontario amongst the 65+… The Most Complex 10% of Older Adults Account for 60% of our Collective Health Care Spending. The Least Complex 50% of Older Adults Account for 6% of our Collective Health Care Spending. (ICES, 2012)
Our Dilemma The way in which cities, communities, and our health care systems are currently designed, resourced, organised and delivered, often disadvantages older adults with chronic health issues. As Ontarians, our Care Needs, Preferences and Values are evolving as a society, with increasing numbers of us wanting to age in place.
Why Develop a Provincial Strategy?
Why Develop a Provincial Strategy? In 2011, the province announced a new vision to make Ontario the best place to grow up and grow old in North America. Given our current and future challenges, the development of Ontario’s Seniors Strategy began in 2012 to establish sustainable best practices and policies at a provincial level. With a focus on ensuring equity, quality, access, value and choice , recommendations were developed that could support older Ontarians to stay healthy and independent for as long as possible.
Ontarians Had Their Say! Over 5000 Older Ontarians, 2500 Health, Social and Community Care Providers, and 1000 Caregivers have participated in our online, paper surveys and town hall and stakeholder engagement meetings. Hundreds of Stakeholder Groups representing Older Ontarians, Caregivers, Provider Organizations and Agencies, Professional Bodies, and Business at the Regional, Provincial, National, and International Level also dialogued and presented their ideas to us as well. Living Longer, Living Well.
Key Strategic Themes/Areas of Focus Supporting the Development of Elder Friendly Communities Promoting Health and Wellness Strengthening Primary Care for Older Ontarians Enhancing the Provision of Home and Community Care Services Improving Acute Care for Elders Enhancing Ontario’s Long-Term Care Environments Addressing the Specialized Care Needs of Older Ontarians Medications and Older Ontarians Caring for Caregivers Addressing Ageism and Elder Abuse Addressing the Unique Needs of Older Aboriginal Peoples Necessary Enablers to Support a Seniors Strategy for Ontario
The Report Recommendations 33 Non-Health Recommendations that focus on issues that examine the development of elder-friendly communities , housing, transportation, ageism and elder abuse and the needs of special populations like our aboriginal or LGBTQ populations . 133 Health Recommendations that span the continuum of care from health promotion and healthy living to the delivery of health, social and community care services .
Understanding Our Choices
Our Future Will Cost Us More… (Ontario Health Care Spending Predictions, MOHLTC). 8.0 2010 2030 7.0 6.0 5.0 $Billions $24 billion 4.0 3.0 2.0 1.0 <1 1-4 5-9 10-14 15-19 20-24 25-29 30-34 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90+ 20
Our Future Requires Choices… Doctors 23.0% Hospitals 34.5% Drugs 7.6% Other Long-Term Care 14.6% Homes 8.0% Community Capital Care 2.5% 6.2% (Ontario Health Care Spending in 2011-12, MOHLTC).
What We are Learning in Ontario… Current Projections see the need for Long-Term Care (LTC) increasing to 238,000 Ontarians in the next two decades (Conference Board of Canada, 2011). Supply of LTC Beds ≠ Demand for LTC Beds across Ontario 37% of hospitalized Ontarians designated as ALC-LTC could be maintained at home with community care supports. (The Change Foundation, 2011) In 2011/2012 Ontario spent 3.7B (8%) on Long-Term Care and 3.1B (6.2%) on Home and Community Care.
Spending on Home and Long-Term Care Across OECD Nations.
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