Mississauga Halton Aging at Home Strategy/media/sites/mh/uploadedfiles/P… · • Senior centered – Services must respond to the needs of seniors. • Community based and integrated

Mississauga Halton LHIN Aging at Home Strategy

2008/09 Investment Overview

July 22, 2008

Integration Priorities & Enabling Strategies

• Alternate Level of Care• Surgical Throughput• Critical Care Capacity• Wait Times• Long-Term Care

Placement Time• Quality of Care –

Patient Perception• Readmissions for Acute

Myocardial Infarction

Local Solutions for Provincial Priorities:

Improving Health System Performance

StrengtheningPrimary Health Care

Preventing & Managing

Long-lasting (Chronic)

Conditions

IntegratingMental

Health & AddictionsServices

EnhancingSeniors Health,

Wellness & Quality of Life

Enabling Strategies: • Information and

Technology Solutions

• Human Health Resources Planning

• Promotion and Prevention

• Education and Knowledge Sharing

• Transportation• Easy Movement

Through the System











Improving Health System Performance

StrengtheningPrimary Health Care

Preventing & Managing

Long-lasting (Chronic)

Conditions

IntegratingMental

Health & AddictionsServices

EnhancingSeniors Health,

Wellness & Quality of Life







Through the System







Through the System

Aging at Home Investments in Ontario

• Investment of $382.4 M over the next three years.

• Increase supports to seniors so that they can live healthy, independent lives in their own homes.

• Identify innovative solutions that are more responsive to seniors needs and allow them to continue to live in comfort in their own homes.

• Help provide more equitable access to health care by matching the need of the local senior population with the appropriate support services.

• Over the next three years, a minimum of 20% of the LHIN funding must support innovative approaches to ensure equitable access to services for a diverse population, including:

• Partnerships with non-traditional providers that allow and recognize “informal services”• New services that include prevention and wellness • People from like groups (e.g., cultural, linguistic) delivering informal care such as

friendly home visits, telephone calling and transportation to appointments

• LHINs’ Aging at Home plans will contribute to system improvement and transformation:

• Reduced pressures on health care system, particularly hospitals and long-term care homes• Sustainable integrated community services for seniors and their care providers• Seniors’ dignity, independence and satisfaction

Aging at Home Strategy – Innovation and Results

MH LHIN’s Key Guiding Principles• Senior centered – Services must respond to the needs of seniors.

• Community based and integrated with broader health care system.

• Equitable – recognize demographic and geographic challenges.

• Cost-effective – best care at optimal cost recognizing benefits of volunteerism and developing local community responses.

• Results oriented – results defined and measured.

• Local community oriented – build on capacity in local neighbourhoods and within communities of common culture (e.g. ethno-cultural, linguistic, religious).

• Of experiencing a medical crisis and ending up in Emergency Departments• Lingering in hospital awaiting a more suitable place (ALCs), or are inappropriately admitted to a LTC home because of insufficient community supports

• Consideration of services to meet client’s cultural and linguistic needs, and specific disease requirements

Aging at Home Target Groups

• Supportive measures designed to prevent deterioration into crisis and/or institutionalization

3 Year Allocation for Mississauga Halton LHIN

$0

$5,000,000

$10,000,000

$15,000,000

$20,000,000

$25,000,000

$30,000,000

$35,000,000

2008/09Initial Investment

2009/10 Planned Base Increase

2010/11Planned Base Increase

$7.7 M(~23%)

$19.1 M(~57%)

$33.7 M(100%)

Highlight of Mississauga Halton LHIN 2008/09 Investments• Enhance supports for seniors/families affected by mental illness and/or

behavioural difficulties.

• Increase supports for daily living (housing options for seniors).

• Create capacity to meet the needs of hospitalized patients who no longer require acute care.

• Expand support for residents of long-term care homes.

• Enhance palliative care services.

• Increase seniors’ adult day programs.

• Expand health promotion and wellness initiatives.

Investments in 2008/09

2008/09 Aging at Home Investment

$7,555,198TOTAL

$1,294,997Adult Day & Respite Programs

$410,000Prevention and Wellness Education and Training Programs

$553,333Specialized Geriatric Services

$3,645,000Transitional Care Programs

$400,000ASSIST Model Implementation

$1,251,868Supports for Daily Living

Investment2008/09 Deliverable

Proposed Initiatives are Designed to:Proposed Initiatives are Designed to:

• Develop sustainable and increased community capacity

• Provide cost effective solutions to institutional care

• Support seniors to live healthy and independent lives in their homes longer

• Ensure consistent best practices across the region

• Ensure effective and efficient processes

• Commitment to performance improvement

• Build on existing operational infrastructure

2008-09 FUNDING

Project DescriptionService ProviderName of Project

$1,251,868Sub-Total

$662,527Expansion of current capacity in 5 buildings where service is offered in order to allow identified seniors requiring service to age at home.

Peel Senior LinkSupports for Daily Living

$53,680Increase in evening and night supervision to allow the residence to age at home.

Ivan Franko Home (Mississauga)

Supports for Daily Living

$237,043Extension of a Supports for Daily Living Program into the adjacent apartment tower would result in a further diversion of clients from LTC Homes. With this extension, those clients who have the greatest care needs and require 24/7 support will be targeted.

Oakville Senior Citizens Residence

Supports for Daily Living – Apartment Tower

$165,467Expansion of the existing services will have multiple benefits. Average age in this building is 85+ in years and, service needs and acuity have increased. Increasing the existing units of service to 1.5 hours (90 minutes) per day will avert the admission of stable, healthy seniors to Long-Term Care (LTC) Homes.


Supports for Daily Living – Residential

$133,151This program will allow faster discharge of clients from hospital who require direct hourly monitoring and supervision. It will also divert those clients who do not require hospitalization but could end up in hospital due to episodic illness (i.e. flu) that has created temporary disability.


Supports for Daily Living – Recovery Program

Supports for Daily LivingDefinition: Provides a home-like setting which supports the health, safety, independence and wellbeing of frail seniors and clients with disabilities.

Supports for Daily LivingSupports for Daily Living

Supportive Housing within the Continuum of Care: From THIS:

Supports for Daily Living within the Continuum of Care: To THIS:

Supports for Daily Living – Serving 337 Clients!

Performance Requirements for Supports for Daily Living

• Agreement to implement new model

• Agreement to new cost structure

• Agreement to target hospital ALC clients wherever possible or to identify those who could be diverted from LTC

• #’s to be served

• Implement Common Health Assessment

ASSIST Model

2008-09 FUNDINGProject DescriptionService ProviderName of Project

$400,000Pilot the ASSIST Model. The Model targets adults age 55 or older residing in the Mississauga Halton LHIN to ensure a proactive approach to health promotion, disease prevention and wellness interventions that may delay or prevent onset of disease in the future.

Credit Valley Hospital (The)

ASSIST Model Implementation

ASSIST Model

“ASSIST”: Service Delivery Model for Seniors in Mississauga Halton LHIN

• All-inclusive

• Seamless

• Services for

• Independence of

• Seniors for

• Today and Tomorrow

ASSIST Model

FHTFHT

GPs orSpecialistGPs or

Specialist

GPsGPs

Family Health Team

Family Health Team

Teaching Centres

Teaching Centres

RGPRGP

SeniorsHealth and

Wellness Centre

Care Coordinator(s)Exact Services TBD

SeniorsHealth and

Wellness Centre

Care Coordinator(s)Exact Services TBD

SHWCSHWC

GPsGPs

FHTFHT

Patien

t/Cons

umer

and Ci

rcle

Patien

t/Cons

umer

and Ci

rcle

Patien

t/Cons

umer

and Ci

rcle

of Supp

ort Fo

cused

Servic

e

of Supp

ort Fo

cused

Servic

e

of Supp

ort Fo

cused

Servic

e

Delive

ry

Delive

ry

Delive

ry Central

Information and Referral

Central Information and

Referral

SHWCSHWC

SHWCSHWCGPsGPs

FHTFHT

Tertiary Care

Tertiary Care

Quaternary Care

Quaternary Care

Adult Day Centre

Adult Day Centre

Family Support Family

Support

RespiteRespite

Long Term Care

Long Term Care

Community Services & Agencies

Community Services &Agencies

Emergency Room/ Urgent Care

Emergency Room/ Urgent Care

Acute,Specialist

s

Acute,Specialist

s

Transitional Care Programs


$3,645,000Sub-Total

Halton Healthcare Services Corporation

20 Acute Transitional Beds

$2,625,00040 additional acute care beds, on an interim basis (projected 2 years), to serve up to 600 people awaiting LTC Home placement. Patients will receive focused care to regain strength and maintain functional ability.

Trillium Health Centre - Mississauga

20 Acute Transitional Beds

$1,020,000These short-stay beds, offering specific restorative, rehabilitation (transitional) and discharge planning will fill an identified service gap by providing a flow through from acute care to community.

Ernst & Young (Mississauga Lifecare Centre)

Short Stay Restorative Program

Transitional Care Programs

Definition: Provides sub-acute restorative care for seniors awaiting discharge back into the community or LTC homes.

Alternatives to Staying in Hospital More options for seniors who are ready to leave the hospital, but need some time to get well before going home or need more support at home.

This will help alleviate hospital bed and ED pressures.

Specialized Geriatric Services


$553,333Sub-Total

$233,333NP works with a multidisciplinary to support LTCH in managing residents with sudden or semi urgent injuries or illnesses.


Support Residents of LTC through NP Model

$250,000Expansion of geriatric mental health outreach services across Mississauga Halton LHIN and creation of targeted partnerships to strengthen the health and social service continuum responsible for supporting seniors/families affected by serious mental illness and/or behavioural difficulties (e.g. responsive behaviour) residing in community or long term care homes settings.

Halton Healthcare Services Corporation

Expand and Develop Geriatric Mental Health Outreach Services

$70,000Provide expert medical advice and support the development of an accessible, comprehensive, co-ordinated and sustainable continuum of care for seniors within the Mississauga Halton LHIN.


Specialized Geriatric Services Review

Specialized Geriatric Services

Prevention and Wellness


$410,000Sub-Total

$164,000Patient/caregiver/public education, capacity in the education program, implement care guidelines within LTC facilities and educate awareness of DNR roles and responsibilities.

Acclaim HealthMississauga Halton Palliative Care Services

$40,000One-time funding through Mississauga Halton CCAC to Saint Elizabeth to deliver 12 self-management workshops based on the internationally recognized Stanford University’s Chronic Disease Self Management Program. The program consists of a series of 2.5 hour workshops spread over six weeks where seniors with different chronic diseases meet to discuss and learn the skills needed to deal with their condition on a day-to-day basis in an effort to maintain and/or increase life’s activities and enjoyment.

Mississauga Halton Community Care Access Centre

Building Bridges for Better Health

$206,000Implementation of appropriate, individually tailored, progressive program with activities evidenced to improve balance and strength, which are important to preventing falls.


Mississauga Halton LHIN Falls Prevention Project

Prevention and Wellness Education and Training

Adult Day Program ExpansionAdult Day Program Expansion 1200+ Client Days!1200+ Client Days!

2008-09 FUNDING

Project DescriptionService ProviderName of Project

$1,294,997Sub-Total

$192.514Create new Adult Day Program for seniors with Alzheimer’s and other progressive cognitive disorders or dementia in South Etobicoke.

City of Toronto - Wesburn Manor

Alzheimer’s Adult Day Program

$142,918Combine 2 centres into one facility to provide added service as well as accommodate 10 additional clients.

Seniors’ Life Enhancement Centres

Seniors’ Life Enhancement Centres Consolidation

$281,140Open an Adult Day Program (culturally specific) for Chinese frail seniors, seniors with dementia and seniors post-stroke - within the Yee Hong LTCH

Yee Hong LTCHYee Hong Continuum of Services for Chinese Seniors

$322,483Proposal recommends establishing a new adult day program in Georgetown, which collaborates with Links2Care, Hamilton Halton Alzheimer Society, MH CCAC, Georgetown Hospital/Supportive Housing Program, Georgetown Seniors Centre.

Region of HaltonHalton Hills Day and Respite Centre

$355,942Increase service in existing locations to serve 25 new clients from Oakville/Mississauga as well as the addition of a preventative program for healthy seniors.

India Rainbow Community Services of Peel

Enhanced Seniors and Caregiver Health, Wellness and Quality of Life

Adult Day / Respite ProgramsDefinition: Provide a range of health and social services to allow seniors with physical or mental impairments to remain independent for as long as appropriate, while allowing caregivers relief from the responsibilities of at-home care giving so they can fulfill work or other obligations.

Going Forward –

Next Two Years (↓ALC)Engage our seniors’ and their families / caregivers to understand their needs to age at home with dignity

Continue to look for innovative approaches to support seniors to “age at home”.

Optimize and increase the capacity of services within the LHIN.

Reduce reliance on LTC beds and hospitals.

Preventive and wellness services and partnerships with non-traditional providers.

Culturally sensitive options for service delivery including seniors helping seniors.

Mississauga Halton LHIN �Aging at Home StrategyIntegration Priorities & Enabling StrategiesAging at Home Investments in OntarioAging at Home Strategy – Innovation and ResultsMH LHIN’s Key Guiding PrinciplesSlide Number 6Aging at Home Target Groups3 Year Allocation for Mississauga Halton LHINHighlight of Mississauga Halton LHIN 2008/09 InvestmentsSlide Number 102008/09 Aging at Home InvestmentSlide Number 12Slide Number 13Slide Number 14Slide Number 15Slide Number 16Slide Number 17Slide Number 18Slide Number 19ASSIST ModelSlide Number 21Slide Number 22Transitional Care Programs Alternatives to Staying in Hospital Specialized Geriatric ServicesPrevention and WellnessSlide Number 27Slide Number 28Going Forward – Next Two Years (↓ALC)

Documents

Mississauga Halton Aging at Home Strategy/media/sites/mh/uploadedfiles/P… · • Senior centered – Services must respond to the needs of seniors. • Community based and integrated