1. health and fitness

2015/16 M-SAA Schedule Refresh Education Session
November 12, 2014 and November 14, 2014
South West LHIN
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Agenda
• Structure
• Context
o Why a Schedule refresh?
o Planning for a Schedule refresh – CAPS
o M-SAA Schedule Refresh Content
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Timelines
Additional Resources
M-SAA Indicator Education
Completing the CAPS for 2015/16
Next Steps & Discussion
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M-SAA Schedule Refresh Structure
Comprehensive Consultation through Multiple Tables
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Context
Why a 2015/16 CAPS and M-SAA Schedule Refresh?
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The LHINs and community based Health Service Providers (HSPs)
entered into a M-SAA for a three year period effective April 1, 2014
to March 31, 2017.
The LHINs now need to review the M-SAA Schedules and may need
to update or confirm the budgeted financial data, service activities
and performance expectations for Year 2 (2015/16) of the current
Agreement.
In order to facilitate the refresh of M-SAA Schedules B1, B2 and
E2a, HSPs will be required to submit a planning document known as
the Community Accountability Planning Submission (CAPS).
The information provided in the CAPS by the HSP will be used to
populate the M-SAA Schedules for 2015/16 and the Quarterly
Reports in SRI.
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Context
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It is recognized that LHINs may have completed the 2014-17
CAPS/MSAA processes based on the following 3 approaches:
- Schedules negotiated for first year only
- Schedules negotiated for first year only and simply replicated
for 2015/16 and 2016/17 based on the 2014/15 CAPS
information submitted
- Schedules were negotiated for all 3 years of the agreement
Regardless of how the LHINs approached the CAPS process during
the 2014-17 MSAA, there is a NEW CAPS form within SRI for
2015/16 (and 2016/17) that must be filled out.
This new CAPS form serves as the source document for the
quarterly reports in SRI, and as such needs to be opened and
populated to capture data for 2015/16.
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M-SAA Schedule Refresh
Schedule
A
Title
Description
1. Description of Services
Describes the services delivered by the HSP
*OPTIONAL Schedule refresh for 2015/16
2. Population & Geography
*OPTIONAL Schedule refresh for 2015/16
B
1. Total LHIN Funding Service Plan
*If making changes to 15/16 or 16/17 data,
CAPS & Schedule refresh required
Describes the HSP client populations and
geography served
Describes the financial and statistical status of
the HSP.
2. Clinical Activity – Summary
*If making changes to 15/16 or 16/17 data,
CAPS & Schedule refresh required
C
Reports
Identifies and sets due dates for HSP reporting
D
Directives, Guidelines, Policies &
Standards
Identifies applicable MOHLTC policies. Changes
for 2015/16 will include addition of the Personal
Support Services Wage Enhancement Directive
(2014)
*Mandatory Schedule refresh for 2015/16
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M-SAA Schedule Refresh
Schedule
E
Title
Description
1. Core Indicators
Identifies indicators, standards and local performance
requirements
*Mandatory Schedule refresh for 2015/16
2a. Clinical Activity Detail
*If making changes to 15/16 or 16/17 data,
CAPS & Schedule refresh required
2b. CHC Sector Specific Indicators
*Mandatory Schedule refresh for 2015/16
2c. CMH&A Sector Specific Indicators
2d. CSS Sector Specific Indicators
2e. CCAC Sector Specific Indicators
*Mandatory Schedule refresh for 2015/16
3a. Local Indicators & Obligations
*OPTIONAL Schedule refresh for 2015/16
F
Project Funding Agreement Template
Template used for funding special projects
G
Compliance
Form completed by the HSPs Board of Directors to
declare that the HSP has complied with the terms of the
Agreement
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Timelines
Completing the 2015/16 CAPS & M-SAA Schedule Refresh
Target Dates
Nov. 4, 2014
Nov. 12, 2014 and
Nov. 14, 2014
Nov. 3, 2014 –
January 9, 2014
(10 weeks)
January 9, 2015 –
Feb 2, 2015
(3 weeks)
Feb 2, 2015
March 9, 2015
March 17, 2015
April 1, 2015
Key Activities
2015/16 CAPS refresh available on SRI
Health Service Provider (HSP) 2015/16 CAPS & M-SAA Schedule
refresh education session
Completed HSP CAPS (must be submitted by January 9, 2015)
LHIN review of CAPS refresh, consultations on M-SAA refresh
indicators, population of Schedules, and final M-SAA Schedule
amendments
2015/16 M-SAA Schedule amendment letters provided to HSPs
HSP Board Approval of 2015/16 M-SAA Schedule amendments
LHIN Board Approval of 2015/16 M-SAA Schedule amendments
Year 2 of the current 2014-17 M-SAA comes into effect
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M-SAA Indicator Education
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Overview
• Summary of Indicators & Technical Specification
o Core Indicators
o Community Health Centres (CHC) Indicators
o Community Care Access Centres (CCAC) Indicators
o Community Service Sector (CSS) Indicators
o Mental Health & Addiction (MH&A) Indicators
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Indicator Work Group Focus & Approach
• Review current indicators and develop
recommendations to update and reduce
the number of indicators
• Align existing indicators with pan-LHIN
imperatives
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Core (All Sectors)
Performance Indicators
 Fund type 2 balanced budget
 Proportion of budget spent on administration
 Variance forecast to actual expenditures
 Percentage total margin
 Service activity by functional centre
 Variance of forecasted to actual units of service
 Number of individuals served
 Percentage of Alternative Level of Care (ALC) days
(closed cases)
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Core (All Sectors)
Explanatory Indicators
 Cost per individual serviced (by program/service/functional centre)
 Cost per unit of service (by functional centre)
 Client experience
 Plant operations (NEW)
 Volunteer services (NEW)
 Information systems support (NEW)
 General administration (NEW)
Details:
– New explanatory MIS functional centres for ‘Proportion of
Budget Spent on Administration’ indicator (definition remains as
per OHRS specifications)
– Provides more granularity and better understanding
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Community Care Access Centre
Performance Indicators
 Wait Time From Hospital Discharge to Service
Initiation (Hospital Clients) (90th and 50th
Percentile) (formerly titled ‘Wait Time From Hospital
Discharge to Service Initiation (Hospital Clients) (90th
Percentile)’)
 Wait Time for Home Care Services –
Application to First Service (Community Setting)
(90th and 50th Percentile)
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Community Care Access Centre
Explanatory Indicators
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Wait time from hospital discharge to service initiation (hospital
clients) (short stay acute, short stay rehab, long stay complex)
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Wait time for home care services – Application to first service (short
stay acute, short stay rehab, long stay complex)
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Average monthly cost per episode (adult short stay acute, adult
long stay complex, end of life, children medically fragile)
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Clients with MAPLe scores high and very high living in the
community supported by CCACs
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Client placed in LTCHs with MAPLe scores high and very high as a
proportion of total clients placed
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Community Care Access Centre
Explanatory Indicators Cont’d
 Percentage of adult home care patients who received their first
nursing visit within five days of the date they were authorized for
nursing services (NEW)
 Percentage of adult home care patients with complex needs who
received their first personal support visit within five days of the date
they were authorized for personal support services (NEW)
Details:
– Currently reported to the MOHLTC
– Public reporting by HQO to begin November 2014
– Data capture to be expanded in November 2014
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Community Support Services
Explanatory Indicators
• Number of persons waiting for service (by
functional centre)
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Community Support Services
Developmental Indicators
• Average number of days waited for first
service (by functional centre)
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Community Health Centres
Performance Indicators
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Cervical cancer screening
Colorectal Screening rate
Inter-professional diabetes care rate
Influenza vaccination rate
Breast cancer screening rate
Periodic health exam
Access to primary care clinical service
Retention Rate (for NPs and GPs) (NEW)
Details:
– Replaces ‘Vacancy Rate’ indicator
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Community Health Centres
Performance Indicators Cont’d
* Periodic Health Exam (Retired)
Details:
– No longer best practice
– Has little impact on health outcomes
* Vacancy Rate (for NPs and Physicians)
(Retired)
Details:
– Small cell sizes
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Community Health Centres
Explanatory Indicators
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Emergency visits best managed elsewhere
Client satisfaction – Access
Clinical support staff per primary care provider
Interpretation (formally titled ‘Cultural Interpretation’)
Exam rooms per primary care provider
New grads/new staff
Number of new patients
Non-Primary Care activities
Number of registered clients
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Community Health Centres
Explanatory Indicators Cont’d
Specialized care
Supervision of students
Third next available appointment
Non-insured clients
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Community Health Centres
Developmental Indicators
• CHC clients hospitalized for Ambulatory
Care sensitive conditions
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Community Mental Health & Addictions
Explanatory Indicators
 Number of days waited from referral/application to initial
assessment complete
 Average number of days waited from initial assessment
complete to service initiation
 Repeat unscheduled emergency visits within 30 days
for mental health conditions
 Repeat unscheduled emergency visits within 30 days
for substance abuse conditions
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Community Mental Health & Addictions
Developmental Indicators
• OCAN Indicator
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Minor Adjustments to Tech Specs
• Proportion of budget spent on administration (Core)
• Wait time from hospital discharge to service initiation (hospital
clients) (CCAC)
• Average monthly cost per episode (adult short stay acute)
(CCAC)
• Clients placed in long term care homes with MAPLe scores
high and very high as a proportion of total clients placed
(CCAC)
• Number of persons waiting for service (CSS)
• Average number of days waited for first service (CSS)
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Completing the CAPS for 2015/16
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Improving the CAPS
Incorporating feedback from previous CAPS processes
HSP and LHIN feedback identified the following high level
themes:
Simplify forms.
Reduce errors through early testing.
Updated OHRS functional centres.
New Transfer Payment Business Entities (TPBE) for
Sessional Fees.
o Additional lines to report physiotherapists and chiropractors.
o Updated mandatory stats to comply with OHRS.
o Updated edit checks.
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Enhancements for Future Consideration
Continuous CAPS improvement
• The CAPS file may be redeveloped for a
2016/17 refresh to allow LHINs and HSPs
to refresh planning targets, if the LHIN
chooses to do so or if it is required.
• In the effort of continuous improvement of
tools and processes, a further evaluation
will be conducted following the completion
of the 2015/16 CAPS & MSAA Schedule
refresh process.
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Completing the CAPS
Community Annual Planning Submission Tool
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Go to
https://www.sri.moh.gov.on.ca/UserRegistration/faces/login/index.jsp
If you are already registered, you can follow the red arrow and click
“SRI Submissions”. If not, you can follow the purple arrow and
click “Register Here”
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Checking Out Your CAPS
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Following the instructions and steps in the CAPS User Guide will
eventually lead you to the opportunity to “Check Out” and start
completing your CAPS (picture shows 2014/15, but the year will be
15/16)
https://www.sri.moh.gov.on.ca/UserRegistration/faces/login/index.jsp
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Main Page
• When the CAPS file is first
launched the following Menu
Page will display. This page
provides links to each form
contained within the CAPS.
• Note: The ID Edit Check will
fail if you do not “Select a
LHIN” on this Main Page
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Refreshing the Information
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All data from the 14/17 CAPS has been carried over in SRI. The first three
columns will show the 14/15, 15/16 and 16/17 Financial/Service data from
the last CAPS. The next two columns in yellow will allow you to refresh the
information for 15/16 and 16/17 if required.
The yellow columns will be pre-populated based on the blue columns.
If there are no changes to make for HSPs that have already submitted a 3year CAPS, the file simply needs to be checked out and checked in (with no
additional changes made).
CAPS Completion Expectations
• Changes to a CAPS include:
o Any new LHIN base investment that has been
made in 2014/15
o Any service activity impact from base
investments made in 2014/15
o Any material changes based on data quality
Note: Similar to last year, in the absence of definitive funding targets, CAPS will be
based on a planning assumption of 0% base adjustment. CAPS should be prepared to
maintain service levels within the 0% planning assumption.
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Commenting in your CAPS
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Comments: The Comments column should be used to explain
differences between the budgets across the years. The comments
provide clarification and will help the LHIN understand why
reallocations have been made between functional centers and
understand why budget changes are being made by the HSP.
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Verifying the Edit Checks
• Green happy faces 
indicate successful edit
checks. Red sad faces 
indicate failed edit checks,
which must be corrected
before submitting the
CAPS
• If you see a red sad face,
a description of the
problem to be resolved
will appear in the
Message Area of the row.
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Checking In Your CAPS
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After you have entered all information and passed the edit checks
you are ready to upload your CAPS to SRI again.
Checking In your CAPS into SRI is similar to when you Checked Out
your CAPS from SRI
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Submitting CAPS to SRI
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You can now submit the report. To do so, right click and select
“Submission Status” and then “Submit”. If it does not work, you
may need to wait a few minutes so that the upload will take.
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Main Contacts
• If you have any questions about the CAPS
that you have “Checked Out” from SRI,
please call or email your LHIN contact
• Main Contacts at each of the LHINs is
available within the User Guide (pg. 27)
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Next Steps
• The South West LHIN holds Education Session
on November 12th and 14th 2014.
• 2015/16 CAPS available on SRI Nov 4, 2014.
• HSPs given 9 weeks to submit Board approved
CAPS (Nov 4 – Jan 9)
• LHIN Communication
• Agencies should expect frequent emails from the
LHIN regarding FAQs and provincial communiques
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