Central East CCAC Board Agendahealthcareathome.ca/centraleast/en/who/2016_Agendas... · 2016. 8. 30. · Central East CCAC Board Meeting – May 11, 2016 Page 1 of 4 CENTRAL EAST

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Central East CCAC Board Agenda

Date: Tuesday, June 28, 2016 Place: Central East CCAC, Whitby Branch, Durham Room

Time: 6:30 p.m. Teleconference Line: 1 866 232 9443 Participant Passcode: 2578505#

Agenda Item

Action Required

Presenter

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1. Introductory Items

1.1. Call to Order L. Lifchus

1.2. Confirmation of Quorum L. Lifchus

1.3. Approval of Meeting Agenda X X L. Lifchus

1.4. Declaration of Conflict L. Lifchus

2. Central East CCAC Transition update X K. Ramsay

3. Board Education/ Generative Discussion Vl-1

3.1. Medical Assistance in Dying (MAiD) X J. Gardner

4. Minutes of Previous Meeting, Action Items and

Business Arising

4.1. May 11, 2016 Board Meeting Minutes, June 8,

2016 Special Board Meeting Minutes and Action

Items

X X L. Lifchus

5. Reports

5.1. CEO Report to the Board X X K. Ramsay

5.2. PQE Committee (draft Minutes) X Part III X N. Crow

5.3. Finance Committee (draft Minutes) X Part IV X D. Stringer

5.4. Audit Committee (draft Minutes) X Part IV X D. Stringer

5.5. Governance Committee (draft Minutes) X Part V X G. Lounsbury

5.6. Report of the Chair Part V X L. Lifchus

5.7. OACCAC Report

Vl-4 X L. Lifchus

Persons who need accommodation and those needing an alternative format of meeting material,

may email a request to the meeting coordinator.

The Central East CCAC is a scent-free workplace. Please refrain from wearing scented products. Thank you.

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Agenda Item

Action Required

Presenter

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Policy

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6. New Business

6.1. M-SAA Compliance X D. Stringer

7. Correspondence X K. Ramsay

9. Adjournment X L. Lifchus

Central East CCAC Board Meeting – May 11, 2016 Page 1 of 4

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE

BOARD MEETING

MINUTES

Wednesday, May 11, 2016 Central East CCAC - Whitby Branch, Durham Room

6:30 p.m. – 8:30 p.m.

Present: Len Lifchus (Chair), Kathryn Ramsay (CEO), Gary Lounsbury, Carmen Rapati, Patrick Connolly, Michelle Rawnsley, Susan

Donaldson, Glenn Rogers, Sylvia Patterson, Rick Morphew and Derrick McLennon

Regrets: Nicola Crow, Andy Williams

Guests: Lisa Burden, Michelle Nurse and David Stringer Recorder: Yvonne Norris

1.0 Introductory Items

1.1 Call to Order

The meeting call to order at 6:32p.m.

It was noted that the Board will be losing two valuable Board members

as tonight is their final meeting. Glenn Rogers and Susan Donaldson’s terms are up this year and they were thanked for their years of dedication, guidance and contributions.

1.2 Quorum

A quorum was present

Approval of Meeting Agenda

MOTION: TO APPROVE THE AGENDA OF MAY 11, 2016

MOVED: Gary Lounsbury

SECOND: Glenn Rogers CARRIED


1.3 Declaration of Conflict (Policy Reference V-A-3)

No conflicts were declared.

2.0 Central East CCAC Transition Update

It was noted that Dr. Bob Bell was a guest speaker at the May 10th Central

East LHIN Governance Advisory Council Governors Forums where he encouraged the Central East CCAC Board members to forward their names to the Central East LHIN Board for consideration. K. Ramsay did have the

opportunity to speak to Dr. Bell regarding the Central East CCAC funding challenges.

It was noted that information sharing meetings with the Central East LHIN and the Central East CCAC Senior Teams continue. Then next three meetings

will take place May/June 2016 and will provide further information regarding service provider contracts and relationships, human resources and

information systems.

3.0 Board Education / Generative Discussion

3.1 Patient Story

The Caring for the Dying patient story was shared with the Board to continue

to support Board members to better understand what matters to the Central East CCAC patients.

3.2 Personal Support, Adult Therapy and School Waitlist Trends

A presentation on Personal Support, Adult Therapy and School waitlists was provided. The presentation, addressed the challenges of growth in the

Central East CCAC waitlist, patient complexity and patient needs.

It was noted that additional funding is required to address the growing waitlists. The Central East CCAC continues to advocate for additional base budget dollars from the Central East LHIN to address the financial pressures.

It was noted that the both the PQE Committee and Board members would

benefit from education on the new physician assisted dying legislation, and how will this legislation impact the Central East CCAC.

ACTION: K. Ramsay to add education session on new physician assisted dying legislation to board education session calendar.

4.0 Minutes of Previous Meeting, Action Items and Business Arising

4.1 April 13, 2016 Board Meeting Minutes and Action Items

The Minutes and Action items for the April 13, 2016 Board Meeting were reviewed with no changes noted.


MOTION: TO APPROVE THE APRIL 13, 2016 BOARD MEETING MINUTES

AND ACTION ITEMS

MOVED: Patrick Connolly

SECOND: Carmen Rapati CARRIED

MOTION: TO APPROVE THE APRIL 13, 2016 IN CAMERA BOARD MEETING

MINUTES AND ACTION ITEMS

MOVED: Michelle Rawnsley

SECOND: Patrick Connolly CARRIED

5.0 Reports

5.1 CEO Report to the Board

The April, 2016 CEO Report to the Board was presented, as circulated.

It was favourably noted that the Central East CCAC has begun to utilize a new wound care product that will improve the quality of life for patients,

improve healing time and decrease wound care costs.

It was also highlighted that the Central East CCAC Community Palliative Team has been nominated for the OACCAC Systems Partnership Award. The Central East CCAC and our Service Provider partners developed a combined

palliative care delivery model to provide integrated care to improve the patient care, and patient and family experience for our palliative patients.

Award winners will be announced at the OACCAC Conference banquet.

5.2 PQE Committee The PQE Committee minutes were presented, as circulated.

5.3 Finance Committee

The Finance Committee Minutes were presented, as circulated, It was noted that the Central East CCAC finished the 2015-2016 fiscal year in

a balanced position.

5.4 Audit Committee

It was noted that the Central East CCAC Auditors will present the draft Audited Financial Statements at the June 7th Audit meeting, and will then be

presented to the Board for review and approval at a teleconference on June 8, 2016.

It was noted that June Board schedule will vary from the usual schedule.


ACTION: R. Russell to send the Board members an email listing all of the June Board and committee meetings.

5.5 Governance Committee

It was noted that the Governance committee reviewed all the Board and committee evaluation responses, which were very encouraging.

ACTION: Each Committee Chair was asked to take their Committee evaluation responses to their June Committee meeting for a review and

discussion, and to provide any feedback to the Governance Committee.

5.6 Report of the Chair

L. Lifchus thanked the remaining Board committee members for agreeing to

stay on until the transition of the CCAC into the Central East LHIN.

L. Lifchus noted he will be accompanying and introducing K. Ramsay, as our new CEO, to all of the Central East region MPPs. To-date two meetings have taken place; Liberal MPP Jeff Leal and PC MPP Laurie Scott, and a meeting

with Liberal MPP Lou Rinaldi is scheduled for May 13, 2016.

5.7 OACCAC Report

L. Lifchus provided the OACCAC report.

6.0 New Business

No new business

7.0 Correspondence

Glenn Rogers and Susan Donaldson briefly shared their memories of their

time as a Central East CCAC Board member and bid farewell to the Board Committee.

8.0 Adjournment of meeting

MOTION: TO ADJOURN MEETING AT 8:15 P.M.

MOVED: Sylvia Patterson CARRIED

Len Lifchus, Chair Date

Central East CCAC Board Meeting – June 8, 2016 Page 1 of 2

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE

SPECIAL BOARD MEETING

MINUTES

Date: June 8, 2016

Time: 6:00 pm

Present: Len Lifchus (Chair), Kathryn Ramsay (CEO), Gary Lounsbury,

Carmen Rapati, Patrick Connolly, Michelle Rawnsley, Andy Williams, Sylvia Patterson, Rick Morphew and Derrick McLennon

Regrets: Susan Donaldson; Nicola Crow

Guests: David Stringer and Joe Bozec

Recorder: Kathryn Ramsay

1.0 Introductory Items

1.1 Call to Order

The meeting was called to order at 6:02 p.m.

1.2 Quorum

A quorum was present.

1.3 Approval of Meeting Agenda

MOTION: TO APPROVE THE AGENDA OF JUNE 8, 2016.

MOVED: Derrick McLennon

SECOND: Rick Morphew CARRIED

1.4 Declaration of Conflict (Policy Reference V-A-3)

It was noted that Glenn Rogers had been appointed to the Central East

LHIN Board of Directors and had submitted his resignation effective

Tuesday June 7, 2016 and therefore not present this evening. No other

conflicts were declared.

Central East CCAC Board Meeting – June 8, 2016 Page 2 of 2

2.0 Audit Committee

2.1 Review and Approval of the Audited Financial Statements

It was noted that the Audit Committee met with the Auditors both with

management present and without management present, and the

Auditors noted no issues. Based on the opinion of the Auditors and the

discussion with them, the Audit Committee recommended approval of

the audited financial statements and annual reconciliation reports.

MOTION: TO APPROVE THE AUDITED FINANCIAL

STATEMENTS AND ANNUAL RECONCILIAION REPORT FOR THE

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE, THE

CENTRE FOR COMPLEX DIABETES CARE PROGRAM FINANCIAL

STATEMENTS AND ANNUAL RECONCILIATION REPORT AND THE

ONTARIO DIABETES STRATEGY ANNUAL RECONCILIATION

REPORT FURTHER TO THE RECOMMENDATION OF THE AUDIT

COMMITTEE.

MOVED: Gary Lounsbury

SECOND: Derrick McLennon CARRIED

3.0 Adjournment of meeting

MOTION: TO ADJOURN MEETING AT 6:08 P.M.

MOVED: Patrick Connolly CARRIED

Len Lifchus, Chair Date

ACTION ITEMS FROM

May 11, 2016

BOARD MEETING

Action Item

Responsibility Time Line Status

1. K. Ramsay to add education session on

new physician assisted dying legislation to board education session calendar.

K. Ramsay N/A Complete

2. R. Russell to send the Board members an email listing all of the June Board and

committee meetings.

R. Russell May 31, 2016 Complete

3. Each Committee Chair was asked to take their Committee evaluation responses to

their June Committee meeting for a review and discussion, and to provide any feedback to the Governance Committee.

Committee Chairs June 28, 2016 to be confirmed

June 2016 Page 1 of 5

The Central East CCAC

CEO Report to the Board

June 2016

Outstanding Care Partner

Engage with clients, caregivers and partners to coordinate quality home and community care

that promotes safe independence, drives optimal health outcomes and delivers a positive

experience.

Alternate Level of Care (ALC) Strategies Project

The Central East CCAC recently participated in an ALC Strategies Project conducted by the

consulting firm Optimus SBR, as commissioned by the Central East Executive Committee

(CEEC). This LHIN-wide initiative specifically focused on how to reduce the designation of, or

at risk of being designated ALC in the Central East LHIN. The CEEC tasked Optimus SBR with

the following:

Analyze ALC trends in the Central East LHIN with comparative performance across

Ontario;

Identify ALC strategies already deployed within the Central East LHIN that have achieved

improved outcomes and show the greatest opportunity for further investments;

Identify alternative or additional ALC strategies that have proven successful in other

communities in Ontario and Canada;

Identify gaps in resources (e.g. system capacity, expertise, funding, Human Resources)

and other barriers (e.g. legislative and regulatory framework; patient and family specific

issues) that must be addressed to achieve improved system performance and better

options for patients.

The Central East CCAC provided an extensive presentation slide deck to Optimus SBR early in

the project that included relevant CCAC data, a review of ALC reduction initiatives, as well as

challenges and recommendations relating to the ALC issue in Central East. Laterally, the CCAC

provided extensive information to Optimus to support a more enhanced examination of the

challenges related to the CCAC providing support to support the discharge of patients

designated ALC to long-term care. The report identified that the ALC challenges in the Central

East CCAC can primarily be attributed to ALC patients waiting for long-term care.

At the end of June, 2016, the CEEC will meet with Dr. Bob Bell, Deputy Minister of Health and

Long-Term Care to review key findings of the report related to ALC challenges, drivers and

constraints in the Central East LHIN, and potential options for improvement for patients


awaiting an Alternate Level of Care in the Central East LHIN and the province more broadly.

The recommendations that will be given to Dr. Bell for the Ministry’s consideration include CCAC

funding to reduce the personal support waitlist.

Outstanding Care Partner Outstanding System Partner Outstanding Place to Work

Strategic Goals

Optimize Health Outcomes ☒ Balance Our Budget

☐ Develop Our People ☐

Provide Comprehensive System Navigation

☒ Collaborate with our

Community Partners Services

☒ Provide Healthy Safe

Workplaces

☐

Design Patient-Centric Programs

☒ Deliver High Value, Outcome-

based Care

☒ Support Flexible Work

Environments

☐

Promote Safe Independence ☐ Expand Partnerships

☐ Be an Innovative Learning Organization

☐ Ensure Quality and Safety

☐ Enable Service Excellence ☐

Medical Assistance in Dying (MAiD)

Prior to February, 2015, the Criminal Code of Canada prohibited Canadians from consenting to

take their own life or from assisting another to take their own life. In the February, 2015 Carter

v Canada decision, the Supreme Court of Canada ruled that it was a Charter of Rights and

Freedoms violation to “prohibit physician assisted death for competent adults who had clearly

consented to death and who had a grievous and irremediable medical condition (including an

illness, disease or disability) that causes enduring suffering intolerable to the individual in the

circumstances of his or her condition”. Effectively physician assisted suicide was no longer

illegal.

Recognizing that legislation would be necessary to protect practitioners providing such medical

assistance, the Supreme Court gave federal and provincial governments until June 6, 2016 to

enact such legislation. In the interim, patients wishing to access medical assistance in dying

were able to apply for a provincial Superior Court of Justice order enabling that access. The

federal government introduced Bill C-14 to support medical assistance in dying from both

physicians and nurse practitioners and the bill received royal assent on June 17, 2016.

The Ministry of Health and Long Term Care (MOHLTC) has set up referral lines for patients to

access both information about medical assistance in dying and clinicians willing to provide the

service. The MOHLTC also recommends that patients apply for an Ontario Superior Court of

Justice order to ensure providers are safeguarded and eligibility of the four criteria clearly

articulated.

The Central East CCAC will provide system navigation in referring patients and clinicians to

MOHTLC resources and in ensuring end-of-life care plans are both well documented and shared

with the care team. The Central East CCAC staff and service providers will continue to support

the delivery of palliative care as appropriate, however they will not participate in the actual

provision of medical assistance in dying at this time until adequate review of the new legislation

has occurred and appropriate processes are developed to support the new legislation.



Strategic Goals




☒ Collaborate with our



Workplaces

☐



based Care

☒ Support Flexible Work

Environments

☐




☒ Enable Service Excellence ☒

Outstanding System Partner

Actively contribute to an integrated and sustainable health system by expanding partnerships,

embracing leading practices and innovation and achieving value for money.

Behavioural Supports Ontario (BSO) Program Office

The BSO Program Office provides quality improvement and project Management leadership to

staff in 68 Central East long-term care homes (LTCHs) and BSO teams serving patients in the

community. Through requests from BSO LTC teams, a project team undertook the creation of

a Behavioural Assessment and Intervention Toolkit which successfully launched in May 2016.

Two capacity building initiatives coordinated by the Program Office, Backfill Funding and the

Geriatric Education Initiative, provided the opportunity for 353 LTCH, community support

services and hospital staff to enhance behavioural support skills to improve care for patients

with responsive behaviours. In addition, the BSO Program Office hosted three successful

student practicums in which the students evaluated Ministry of Health and LTCH inspection data

related to the responsive behaviour protocol, and exploring needs of caregivers of persons with

dementia.

A key project to improve communication included the development and launch of the provincial

and regional BSO Healthline mini-sites.

http://behaviouralsupportsontario.ca/

http://centraleast.behaviouralsupportsontario.ca/

In 2016/17, efforts will be directed to strengthening accountabilities through articulation of

roles and responsibilities and identifying potential amendments to funding letters,

Memorandums of Understanding and Service Accountability Agreements, and continuing to

grow BSO in all sectors with particular focus on improving patient transitions. Planned quality

improvement and capacity building activities include:

Tailoring the BSO Behavioural Assessment Tool for Community use for GAIN BSO

clinicians and the new Primary Care Memory Services teams;

http://behaviouralsupportsontario.ca/

http://centraleast.behaviouralsupportsontario.ca/


Partnering with Central East CCAC to develop an education e-module for the provincial

CCAC Behavioural Assessment Tool to support enhanced communication during the LTCH

application process; and

Continued development of communication strategies such as the development of a health

care provider component on the BSO website to increase resources to support the care

of BSO patients.


Strategic Goals




☐ Collaborate with our



Workplaces

☐



based Care

☐ Support Flexible Work

Environments

☐


☒ Be an Innovative Learning Organization

☒ Ensure Quality and Safety


Finance Report

Since late March, 2016, the Central East CCAC has experienced growth in patient complexity,

patient numbers and service volumes. Personal support and visiting nursing service volumes

are at levels not seen in 8-9 months, essentially overtaking the efficiencies from the many

mitigation strategies we implemented in 2015/16.

We continue to seek out and implement efficiencies. Unfortunately, after many years of

mitigation, new efficiencies typically only provide small incremental savings. The Central East

CCAC has low costs per patient compared to other CCACs across the province and has the

largest personal support waitlist in the province. These two factors hamper our ability to realize

further significant savings without increasing patient risk and potentially increasing hospital ED

visits.

In order to ensure a balanced position at year end, the Central East CCAC has begun to develop

strategies and associated impacts, with an aim to implement the most appropriate initiatives

by mid-July 2016. New base funding is also a key strategy for 2016/17 to mitigate risk and

support a balanced budget. Mitigation strategies have to be implemented early in Q2 2016/17

to ensure a balanced position at year end.

Central East CCAC Waitlists April 1/16 May 1/16 Estimate to Eliminate Waitlist

Adult Therapy Services 247 229 $0.3M

Enhanced Personal Support 1,053 1,113 $4.3M

Personal Support 2,304 2,352 $18.5M


The personal support waitlists continue to grow. We are most concerned with the risk inherent

in those patients on the enhanced personal support waitlist.


Strategic Goals


☒ Develop Our People ☐


☐ Collaborate with our


☐ Provide Healthy Safe

Workplaces

☐


☐ Deliver High Value, Outcome-

based Care

☐ Support Flexible Work

Environments

☐





Page 1 of 3

Performance Quality and Effectiveness Committee

Meeting

Wednesday, June 1, 2016

Central East CCAC - Whitby Branch, Durham Room

6:30 p.m. – 8:30 p.m.

MINUTES

Present: Nicola Crow (Chair), Derrick McLennon, Len Lifchus, Michelle Nurse, Kathryn Ramsay,

Lisa Burden, Dave Stringer, Kathy Romas Jaeger, Garth Johns (guest)

Regrets: Carmen Rapati

Recorder: Terry-Leah McGowan

1. Meeting Agenda and Approval

1.1. Call to Order

Meeting was called to order at 6:28 p.m.

1.2. Declaration of Quorum


1.3. Approval of Agenda

MOTION: To approve the agenda as circulated.

MOVED: Len Lifchus

SECOND: Derrick McLennon CARRIED

1.4. Declaration of Conflicts

No conflicts were declared.

1.5. Approval of Minutes

MOTION: To approve the minutes of May 4, 2016


SECOND: Len Lifchus CARRIED

Page 2 of 3

2. Business Arising

2.1. Q4 2015/16 Organization Performance Report – Improvement Initiative

Focus on Employee Engagement & Absenteeism – Garth Johns

A summary report on Outstanding Place to Work focusing on Employee Engagement,

Absenteeism and Performance Reviews was presented with the following points noted:

The organization is striving to achieve 70% of the Central East CCAC employees feeling

that they are engaged at the workplace. Over the past two quarters, specifically with

quarter four 2015/16, employee engagement declined to 53%. Employees have

indicated that workload, constant change, and transition are the contributing factors for

the decline.

The committee members agreed to commit to working on improving the employee

engagement scores through the transition. It was discussed that attitude, gratitude and

action were very important going forward and that the organization needs to stay

collectively positive through the transition.

Members discussed the role the Board and the committee have in supporting the

organization and staff through the changes. It was noted that keeping employees

informed and providing a perspective from the Board would be appreciated. The Board

Chair committed to attending an all staff meeting after the legislation has been tabled to

provide the Board’s outlook on the transition.

The Central East CCAC absenteeism average in quarter four 2015/16 was 2.97 days with

93% of the absenteeism 3 days or less. The consortium average is 3.24. It was noted

that the absenteeism rate is consistent with the previous seasonal trends. The Central

East CCAC will be rolling out an updated absenteeism program designed to assist

managers to support employees to come to work and decrease absenteeism.

The Performance Review metric continues to be below the organization target; however

the organization Leadership/Management team will be focusing on changing the

organization culture through discussions with staff throughout the year and by

improving the performance assessment tools making them easier to use.

2.2. Operational Plan for Quality Improvement Initiatives (2016/17) – Michelle

Nurse

The Operational Plan for Quality Improvement Initiatives document provided an

overview of the projects that the Central East CCAC will be focusing on throughout the

upcoming year. The document will allow management to review what initiatives are on

track, whether education is required, areas that need attention and the timing of

initiatives.

Discussion ensued regarding whether or not a strategic plan exercise should be

undertaken in September 2016. It was noted that a decision was made earlier not to

complete a strategic planning exercise given the pending transition.

ACTION: Kathryn Ramsay to schedule a meeting in late August or September to

further discuss the need to engage in a 2016/17 Strategic Planning exercise.

2.3. Review of PQE Committee Evaluation Results – Nicola Crow

The results of evaluation were reviewed with the committee, no concerns were noted.

Page 3 of 3

2.4. PQE Year in Review Report – Michelle Nurse A summary report of the committee activities was presented. Members felt that the

report provided valuable and important information that outlined the achievements the

committee. Members agreed that the report should be kept up to date and would be

presented again during the December 2016 PQE Meeting.

It was agreed that the PQE Year in Review Report be brought forward to next Board

meeting and portions of the report will be featured in the Annual General Meeting report

to highlight the committee’s accomplishments.

ACTION: Christine Lomas to add Semi-Annual PQE Review Report to the PQE Agenda

for December 2016.

ACTION: Nicola Crow to provide an overview of the PQE Year in Review Report to next

board meeting.

3. Business Arising

3.1. Risk Event Management Reporting – Kathy Romas Jaeger

The risk events, complaints and compliments, report was provided with a summary that

the risk events have decreased by 5.3% and complaints remaining unchanged when

compared to the previous year. It was noted that the number of privacy breach events

had increased from last year. The main contributing factor was as a result of one event

contributing to multiple patients’ information being breached. Clarification was provided

that every patient involved in a breach is notified by either the Central East CCAC or the

service provider involved and to date; each patient had no further concerns noted after

being notified.

4. Standing Items

4.1 Messages to the Board—Nicola Crow

Committee members identified that an educational piece on Medical Assistance in Dying

and a summary of the Focus on Employee Engagement and Absenteeism report were

topics that should be noted for the Board.

4.2. Risk Management Update—Michelle Nurse

Michelle Nurse provided an update.

Adjournment

MOTION: To adjourn meeting at 8:07 p.m.


__________________________________ _____________________________

Nicola Crow (Chair) Date

Board Finance Committee Meeting –May 04, 2016 Page 1 of 1

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE FINANCE COMMITTEE MEETING

MINUTES May 04, 2016

5:30 p.m.

Attendance: Patrick Connolly, Len Lifchus, Michelle Rawnsley, Andy Williams, Joe Bozec, Kathy Ramsay, Dave Stringer

Recorder: Yvonne Norris

1.0 CALL TO ORDER 5:38p.m.

1.1 Quorum

Quorum was present.

1.2 Declaration Of Conflict (Policy Reference V-A-3) No declaration of conflict.

2.0 APPROVAL OF MINUTES - DEFERRED

3.0 NEW BUSINESS 3.1 Review Draft 2015/16 Financial Statements

Draft Financial Statements were provided for review. J. Bozec and D.

Stringer provided clarification where required. Agreed upon changes will be made prior to presenting to the BDO Auditors on May 9, 2016.

Note – it was agreed that a note be added to the draft Financial Statements regarding the impending dissolution of the Central East

CCAC. J. Bozec confirmed that provincial work is taking place to address this issue. This note may need to be revised prior to Board

approval to reflect what the current legislation is at that time. Also, the note needs to match public disclosure.

MOTION: TO APPROVE THAT THE DRAFT FINANCIAL STATEMENTS AS AMENDED BE FORWARDED TO THE AUDITOR.

MOVED: Michelle Rawnsley SECONDED: Andy Williams CARRIED

4.0 NEXT MEETING

5.0 ADJOURNMENT OF MEETING

___________________ __________________

Patrick Connolly, Chair Date

Board Finance Committee Meeting –June 15, 2016 Page 1 of 3

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE FINANCE COMMITTEE MEETING

MINUTES June 15, 2016

6:30 p.m.

Attendance: Len Lifchus, Patrick Connolly, Michelle Rawnsley, Dave Stringer Teleconference: Joe Bozec

Regrets: Andy Williams, Kathy Ramsay Recorder: Yvonne Norris

1.0 CALL TO ORDER 6:30p.m.

1.1 Quorum Quorum was present.


2.0 APPROVAL OF MEETING AGENDA

MOTION: TO APPROVE THE AGENDA OF JUNE 15, 2016 MOVED: Michelle Rawnsley

SECONDED: Len Lifchus CARRIED

3.0 APPROVAL OF MINUTES

MOTION: TO APPROVE THE MINUTES OF MAY 04, 2016 MOVED: Len Lifchus SECONDED: Michelle Rawnsley CARRIED

4.0 BUSINESS ARISING (Action List) Board Access to CECCAC Policies and Procedures

There were problems with allowing this access through the OACCAC-managed firewalls that secure our network. We have worked with the OA

to update these rules and, as of now, we are okay to proceed. Len Lifchus’ name has been provided as our first test user. We will create his user account and write up a Quick Reference document on how to access

this solution.

Information showing expenses broken out between Patient-Related and non-Patient Related functional centres was provided for the 2015/16 fiscal year.

Functional centre numbers are used provincially however the portfolio names and membership are unique to each CCAC.

Our report stays consistent with the other CCACs reporting structure.


5.0 NEW BUSINESS

5.1 Payment of Obligations Report

The CECCAC is compliant with all of our payments, premiums, remittances and information requirements to external parties such as

CRA.

5.2 Metrics

Documents reviewed with a few areas highlighted: CECCAC Finance Metrics Year Over Year Comparison

o Therapy numbers are down due to reinforcement of adherence to the eligibility criteria

o Personal Support costs per patient are up due to the Year 2

PSW Wage enhancement dollars and patient complexity. o Personal Support and Visiting Nursing numbers are up due to

the increase in patient complexity and numbers.

Q4 Finance Metrics Summary

o Individuals Served document – Personal Support regular waitlist numbers are included in this total.

o Units Purchased document – currently reviewing criteria to include additional patients under Restorative Physiotherapy.

LHIN Benchmarking

o Document reviewed.

5.3 Review of High Level Financial Analysis Document reviewed. A similar version of this document was sent to the Central East LHIN to keep them informed as we continue to

advocate for base funding adjustments to manage growth and reduce waitlists.

The Summary of Surplus and Deficit by Project document was reviewed in detail. Insufficient funding for certain programs and

potential proactive next steps were discussed.

5.4 Detailed Month/YTD Financial Package (Discussion by Exception)

Mitigation Strategies – a number of potential strategies and their impact on the community and our organization were discussed.

Communication with the LHIN regarding the strategies and

implementation timing was discussed.

5.5 Key Messages to the Board Mitigation strategy suggestions and next steps to be presented

to the Board to ensure a balanced position at year end. Potential implementation timeline Communication with the Central East LHIN


6.0 NEXT MEETING

September 21, 2016

7.0 ADJOURNMENT OF MEETING

MOTION: TO ADJOURN MEETING AT 8:00PM CARRIED

___________________ __________________

Patrick Connolly, Chair Date

CECCAC Board Audit Committee Meeting – Minutes: June 07, 2016 Page 1 of 2

CENTRAL EAST COMMUNITY CARE ACCESS CENTRE AUDIT COMMITTEE MEETING

MINUTES

June 07, 2016 Start time: 5:30 p.m.

CECCAC Whitby Branch – Durham Room 920 Champlain Court, Whitby ON

Present: Rick Morphew (Chair), Derrick McLennon, Joe Bozec, Kathy Ramsay,

David Stringer Regrets: Carmen Nisbet Guests: Nigel Allen – BDO, Victoria Hennessy - BDO Recorder: Yvonne Norris

1.0 CALL TO ORDER – 5:31 PM

1.1 Quorum Quorum was present.


2.0 APPROVAL OF AGENDA MOVE TO ACCEPT: Derrick McLennon CARRIED

3.0 APPROVAL OF MINUTES MOTION: TO APPROVE THE MINUTES OF JANUARY 18, 2016 MOVE: Derrick McLennon CARRIED

4.0 NEW BUSINESS 4.1 Review of 2015/16 Audited Financial Statements, ARRs, Audit Report

and Management Report Financial Statements Nigel Allen reviewed the Financial Statements with the Audit Committee highlighting and providing details as required on the Independent Auditor’s Report, statement of operations, changes in net assets, financial position and cash flow.

The deficiency on the Statement of Operations document was noted and was pre-approved by the Board.

The dollar amount to be returned to the MOHLTC is as a result of surplus dollars in the specially funded programs. These dollars will be returned once the MOHLTC completes their reconciliation.

Additional time was allowed to review the Notes to Financial Statements to address any questions from the committee. No concerns were raised by the Committee.

It was noted that in Notes to Financial Statements, Note #1 was added to capture transition language. The auditors spoke to their counterparts provincially to ensure standard language.

CECCAC Board Audit Committee Meeting – Minutes: June 07, 2016 Page 2 of 2

The Auditor’s presented a clean opinion on the financial statements. MOTION: THAT THE AUDIT COMMITTEE APPROVE THE FINANCIAL STATEMENTS AS REVIEWED AT THIS MEETING AND RECOMMEND THEY BE MOVED FORWARD TO THE BOARD FOR APPROVAL. MOVED: Derrick McLennon SECONDED: Rick Morphew CARRIED Draft Independent Letter (letter addressed to Audit Committee) The purpose of this letter, prepared solely for the use of the Audit Committee, is to highlight items the auditors felt should be brought to the attention of the Audit Committee and to confirm their independence. The Auditors reviewed the letter with the Audit committee.

The Summary of Unadjusted Misstatements was reviewed. Balance is immaterial.

No fraud or illegal activities were detected during the course of the audit. Draft Management Letter This is a letter from the Auditor to Management advising of any identified matters which may be of interest to management. The Summary of Matters Identified was discussed with Audit Committee:

Appendix 1 - Appropriate Approval of Journal Entries – Recommendations provided. Management agrees and have implemented these recommendations.

The Auditors went on to acknowledge their appreciation for the cooperation and courtesy shown by Joe Bozec and his staff. Draft Rep Letter This letter outlines what Management, as creators of the Financial Statements, are representing to the auditors. Auditors asked if there was anything unforeseen that could affect the Financial Statements. No concerns were expressed.

5.0 OTHER BUSINESS The Auditors confirmed that the ARR, CCDC ARR, CCDC Financial Statements and the ODS ARR were all clean audits.

6.0 IN CAMERA SESSION

In camera session began at 6:05 p.m. and ended at 6:10 p.m.

7.0 NEXT MEETING – to be determined 8.0 ADJOURNMENT – 6:10 PM

_________________________ ________________________ Rick Morphew, Chair Date

Central East CCAC Governance Committee – May 11, 2016 Page 1 of 2

MEETING OF GOVERNANCE COMMITTEE Wednesday, May 11, 2016

5:30 p.m.

MINUTES

Present: Gary Lounsbury, Sylvia Patterson, Glenn Rogers and Len Lifchus,

Kathryn Ramsay

Recorder: Kathryn Ramsay

1. Call to Order Gary Lounsbury called the meeting to order at 5:32 p.m.

2. Quorum


3. Approval of Agenda

MOTION: TO APPROVE THE AGENDA OF MAY 11, 2016

MOVED: Sylvia Patterson SECOND: Glenn Rogers CARRIED

4. Declaration of Conflicts

G. Lounsbury asked for any declaration of conflicts. None were declared

5. Approval of the Minutes of previous meeting

MOTION: TO APPROVE THE MINUTES OF MARCH 9, 2016.

MOVED: Glenn Rogers

SECOND: Sylvia Patterson CARRIED

Central East CCAC Governance Committee – May 11, 2016 Page 2 of 2

6. Business Arising

No business arising.

7. New Business

7.1. Review of Board and Committee Survey Results Committee members noted the favourable board evaluation responses and the

good constructive suggestions. It was agreed that the results would be distributed to the Committee Chairs; Chairs will then discuss the results with their committee members at the June committee meetings.

Action: Robin Russell to distribute Board Committee evaluations to Committee

Chairs for review and discussion at the June Committee meetings.

7.2. Review of Governance Committee Work Plan

Committee members reviewed the work plan and agreed work is progressing well to year end. Governance Committee evaluation reviewed and no concerns

raised. Reviewed motion that was made at the March 9, 2016 Board meeting to have all of the existing Officers and committee Chairs remain the same for

the upcoming board year, with the exception of Secretary which will be filled by Kathryn Ramsay as the new CEO. Committee members noted that there is a need to replace Glenn Rogers on the Governance Committee given the end

of his term; noted that Andy Williams offered and members in agreement. Also noted that Glenn Rogers sat on the North East Governance Advisory Council

and agreed that Gary Lounsbury will ask Nicola Crowe to be the Central East CCAC representative and if she can’t, Gary Lounsbury will be the representative.

8. Other Business

S. Patterson asked about question regarding concern about director liability given the upcoming CCAC transition. Committee members agreed to have K. Ramsay organize a board liability education session in September.

9. Next Meeting

No June meeting to be scheduled at this time.

10. Adjournment

MOTION: To adjourn the meeting at 6:05 pm.

MOVED:

____________________ ___________________

Gary Lounsbury, Chair Date

__________________________________________

SCHEDULE G – FORM OF COMPLIANCE DECLARATION

DECLARATION OF COMPLIANCE

Issued pursuant to the M-SAA effective April 1, 2014

To: The Board of Directors of the Central East Local Health Integration

Network (the “LHIN”). Attn: Board Chair. From: The Board of Directors (the “Board”) of the Central East Community Care Access

Centre (the “HSP”) Date: June 28, 2016

Re: April 1, 2015 –March 31, 2016 (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, 2014.

The Board has authorized me, by resolution dated June 28, 2016, to declare to you as follows:

After making inquiries of the Chief Executive Officer, Kathryn Ramsay 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, 2010.

Len Lifchus, Central East CCAC Board Chair

Schedule G – Form of Compliance Declaration Cont’d.

Appendix 1 - Exceptions

Article 3.19(a) Provision of Services

The Central East CCAC submitted the SRI reports on time but did not include the variance analysis. The practice in past years has been to submit and review the variance analysis with Central East LHIN staff some time after the reports are submitted. This practice is now ended and SRI submissions will be completed when submitted.

Article 3.1(b) Provision of Services

The Central East CCAC is complaint with the overall service volumes provided in Schedule ‘E’ with a 0.8% variance to budget in 2015/16. Variances (+/-) occur in the specific service categories as the Central East CCAC implements mitigation strategies to deal with growth in patient complexity and patient numbers. Growth funding is not adequate to meet demand. Timely and sufficient funding would enhance our ability to achieve performance in the specific service areas provided in Schedule ‘E’.

2014-2017 M-SAA Declaration of Compliance Checklist

1

In my capacity as CEO of the Central East Community Care Access Centre, I hereby certify that to the best of my knowledge, the Central East Community Care Access Centre has demonstrated compliance to the

responsibilities and accountabilities as detailed in the Declaration of Compliance Checklist attached: Schedule of Exceptions

There is one (1) exception to the certification provided on Schedule G.

Kathryn Ramsay Date

CEO

In my capacity as Board Chair of the Central East Community Care Access Centre, I hereby certify that to the best of my knowledge and upon due enquiry of the Executive Director, the Central East Community Care

Access Centre has demonstrated compliance to the above responsibilities and accountabilities:

Len Lifchus Date

Board Chair

X Recommended to Board Recommended to Board Pending Corrective Actions Listed Below:

Recommended Corrective Actions: Article 3.1(a) i

Corrective Actions Taken: The Central East CCAC has revised past practice and complete SRI reports will be submitted on or before mandated deadlines.


2

Terms of the M-SSA Evidence Sign Off

Notes

ARTICLE 3.0 - PROVISION OF SERVICES 3.1 Provision of Services. (a) The HSP will provide the Services in accordance with:

(i) the terms of the Agreement, including the Service Plan; (ii) Applicable Law; and (iii) Applicable Policy.

SRI Reporting Revenue Canada Reporting Board Meeting Materials Publications and Website

Compliant – The CECCAC has submitted required payments, remittances and

information to Canada Revenue Agency, Hospital of Ontario Pension Plan, Ontario Ministry of Finance, Ontario Ministry of

Health, Canadian Institute of Health Information and other agencies as required.

Not Compliant - The CECCAC has met the required LHIN reporting requirements through SRI, with the exception of the

variance analysis which was one (1) week late. The CECCAC posts required information

on its website.

(b) When providing the Services, the HSP will meet the Performance Standards and Conditions identified in Schedule E.

(c) Unless otherwise provided in this Agreement, the HSP will not reduce, stop, start, expand, cease

to provide or transfer the provision of the Services or change its Service Plan except with Notice to the LHIN, and if required by Applicable Law or Applicable Policy, the prior written consent of the LHIN.

(d) Unless the HSP is a community care access centre, the HSP will not restrict or refuse the

provision of Services to an individual, directly or indirectly, based on the geographic area in which the person resides in Ontario.

SRI Reporting Integrations Official Notices to the LHIN Records

Compliant – The CECCAC overall actual service volumes had a 0.8% variance to

budget. Individuals served were higher than target. Mitigation strategies implemented in

2015/16 resulted in some therapy services coming in under target to offset growth

pressures in other areas. Patient needs were met within the constraints of available

funding.

Not applicable at this time.

Compliant – The CECCAC waitlists clients as permitted by legislation.

3.2 Subcontracting for the Provision of Services. (a) Unless already identified as a subcontracted service in Schedule A, the HSP agrees that the HSP

will not subcontract the fulfillment of all or any part of the HSP’s obligations under this Agreement without the prior written consent of the LHIN. Such consent will be in the sole discretion of the LHIN and may be subject to additional terms and conditions.

If this section applies, refer to article (b), (c), (d) for more information

Schedule A

Compliant – The CECCAC has contracted the bulk of its service provision since 1997 as per

Ministry direction.

3.3 Conflict of Interest. The HSP will use the Funding, provide the Services and otherwise fulfil its obligations under this Agreement without an actual, potential or perceived Conflict of Interest. The HSP will disclose to the LHIN without delay any situation that a reasonable person would interpret as an actual, potential

Disclosure to the LHIN Board Minutes

Compliant – No conflict of interest identified

to date.


3


Notes

or perceived Conflict of Interest and comply with any requirements prescribed by the LHIN to resolve any Conflict of Interest.

3.4 E-health/Information Technology Compliance. The HSP agrees to comply with any technical and information management standards, or solutions, related to architecture, technology, privacy and security set for health service providers by the MOHLTC, eHealth Ontario or the LHIN within the timeframes set by the MOHLTC or the LHIN as the case may be.

Where Applicable Compliant – The OACCAC coordinates this on behalf of CCACs with ongoing dialogue with

the MOHLTC, eHealth Ontario and the LHINS.

ARTICLE 4.0 - FUNDING (b) The HSP may request additional funding by submitting a proposal to amend its Service Plan. The

HSP will abide by all decisions of the LHIN with respect to a proposal to amend the Service Plan and will make whatever changes are requested or approved by the LHIN. The Service Plan will be amended to include any approved additional funding.

H-SIP Forms

Compliant – The CECCAC formally requested

RM&R Enhancement funding in 2015/16 using H-SIP forms.

4.5 Conditions of Funding. (a) The HSP will:

(i) Fulfill all obligations in the Agreement, including the Schedules; (ii) Use the Funding only for the purpose of providing the Services in accordance with

Applicable Law and the terms of this Agreement; (iii) Spend the Funding only in accordance with the Service Plan; and (iv) Propose, achieve and maintain an Annual Balanced Budget.

SRI Audited Financial Statements

Compliant – 4.5 (iii) is modified throughout the year as funding is received for specific

initiatives. 4.5 (iv) requires ongoing advocacy to ensure we have the funds to do the required work.

The CECCAC achieved a balanced position for 2015/16.

4.6 Interest.

(a) Funding will be placed in an interest bearing account at a Canadian financial institution. (b) Interest Income must be used, within the fiscal year in which it is received, to provide the

Services. (c) Interest Income will be reported to the LHIN and is subject to year-end reconciliation.

Bank Statements SRI

Compliant – We bank at RBC and report

interest in our monthly and annual financial statements. Interest is used to provide

services.

4.7 Rebates, Credits and Refunds. The HSP: (i) Acknowledges that all HST and other rebates, credits and refunds it anticipates receiving from

the use of the Funding have been incorporated in its Budget; Also applies to Article 4.7 (ii) and (iii)

Annual Audit SRI

Compliant – All budgeted expenses are net of

the HST rebates. We budget for WSIB refunds, property tax rebates, etc.

4.8 Procurement of Goods and Services. Subject to any direction or guideline issued by the Management Board of Cabinet pursuant to the Broader Public Sector Accountability Act, 2010. (i) The HSP will have a written procurement policy in place that requires the acquisition of supplies,

equipment or services valued at over $25,000 through a competitive process that ensures the best value for funds expended and the HSP will acquire supplies, equipment or services with the Funding through a process that is consistent with this policy; or

Also applies to Article 4.8 (ii)

Evidence of written policy endorsed by Board. Annual Audit

CECCAC has fully compliant procurement policies.


4


Notes

4.9 Disposition. The HSP will not, without the LHIN’s prior written consent, sell, lease or otherwise dispose of any assets purchased with Funding, the cost of which exceeded $25,000 at the time of purchase.

Evidence of reports to the LHIN

Not applicable to date.

ARTICLE 5.0 - REPAYMENT AND RECOVERY OF FUNDING 5.2 Provision for the Recovery of Funding. The HSP will make reasonable and prudent provision for the

recovery by the LHIN of any Funding for which the conditions of Funding set out in subsection 4.5 are not met and will hold this Funding in accordance with the provisions of subsection 4.6 until such time as reconciliation and settlement has occurred with the LHIN. Interest earned on Funding will be reported and recovered in accordance with subsection 4.6.

SRI Annual Recovery Letter from LHIN ARR Audited Financial Statements

Compliant – The Ministry recovers funding that is not spent based on the audited Account Reconciliation Report (ARR).

5.3 Settlement and Recovery of Funding for Prior Years. (a) The HSP acknowledges that settlement and recovery of Funding can occur up to seven years

after the provision of Funding. Also applies to 5.3 (b)

Maintenance of records for seven years

Compliant – All financial records are maintained for a minimum of seven (7) years.

ARTICLE 6.0 - PLANNING & INTEGRATION 6.1 Planning for Future Years.

(b) Multi-Year Planning. The CAPS will be in a form acceptable to the LHIN and will incorporate (i) prudent multi-year financial forecasts; (ii) plans for the achievement of performance targets; and (iii) realistic risk management strategies. It will be aligned with the LHIN’s Integrated Health Service Plan and will reflect local LHIN priorities and initiatives. If the LHIN has provided multi-year planning targets for the HSP, the CAPS will reflect the planning targets.

(d) Service Accountability Agreements. The HSP acknowledges that if the LHIN and the HSP enter into negotiations for a subsequent service accountability agreement, funding may be interrupted if the subsequent accountability agreement is not executed on or before the expiration date of this Agreement.

CAPS M-SAA Negotiation Meetings Quarterly Reporting

Compliant 6.1 (b) The CECCAC submits the CAPS

document and M-SAA as required by the CE LHIN.

6.1 (d) The CECCAC works with the CE LHIN to ensure the M-SAA is fully executed in a timely

manner.

6.2 Community Engagement & Integration Activities (a) Community Engagement. The HSP will engage the community of diverse persons and entities in

the area where it provides health services when setting priorities for the delivery of health services and when developing plans for submission to the LHIN including but not limited to CAPS and integration proposals.

(b) Integration. The HSP will, separately and in conjunction with the LHIN and other health service providers, identify opportunities to integrate the services available to the local health system to provide appropriate, co-coordinated, effective and efficient services.

(c) Reporting. The HSP will report on its community engagement and integration activities as requested by the LHIN, and in any event, in its year-end report to the LHIN.

Communications Plans Integration Discussions Communications to membership or clients Press Releases Websites Engagement Meetings

Compliant – The CECCAC works closely with its community partners. Examples include

Health Links, GAIN, Home First, Assisted Living.


5


Notes

6.3 Planning and Integration Activity Pre-proposals (a) General: A pre-proposal process has been developed to (i) reduce the costs incurred by an HSP

when proposing operational or service changes; (ii) facilitate the HSP to carry out its statutory obligations; and (iii) enable an effective and efficient response by the LHIN. Subject to specific direction from the LHIN, this pre-proposal process will be used in the following instances: (i) the HSP is considering an integration or an integration of services, as defined in the Act

between the HSP and another person or entity; or (ii) the HSP is proposing to reduce, stop, start, expand or transfer the location of Services; (iii) to identify opportunities to integrate the services of the local health system, other than

those identified in (i) or (ii) above; or (iv) if requested by the LHIN.

Also applies to 6.3 (b)

H-SIP Submissions Evidence that the LHIN approved changes

Not applicable to date

6.4 Proposing Integration Activities in the Planning Submission. No integration activity described in subsection 6.3 may be proposed in a CAPS unless the LHIN has consented, in writing, to its inclusion pursuant to the process set out in 6.3 (b). Also applies to Article 6.5 (Definitions)

CAPS Compliant – No formal integration activities

to date. We work with our partners to deliver programs as noted in 6.2.

ARTICLE 7.0 - PERFORMANCE 7.1 Performance. The Parties will strive to achieve on-going performance improvement. They will address

performance improvement in a proactive, collaborative and responsive manner.

Communications with LHIN Quarterly Reports Communications relating to Performance

Compliant – CECCAC has a process in place to

achieve on going performance improvements.

7.2 Performance Factors. (a) A “Performance Factor” is any matter that could, or will, significantly affect a Party’s ability to

fulfil its obligations under this Agreement. (b) Each Party will notify the other Party of the existence of a Performance Factor, as soon as

reasonably possible after the Party becomes aware of the Performance Factor. The Notice will: (c) The recipient Party will provide a written acknowledgment of receipt of the Notice within seven

Days of the date on which the Notice was received (“Date of the Notice”). (d) Where a meeting has been requested under 7.2(b) (iii), the Parties agree to meet and discuss the

Performance Factors within fourteen Days of the Date of the Notice, in accordance with the provisions of subsection 7.3.

Also Applies to 7.3 (a) – Performance Meetings

Written Notice to LHIN or From LHIN Meeting Notes


ARTICLE 8.0 - REPORTING, ACCOUNTING AND REVIEW

8.1 Reporting (a) Generally. The LHIN’s ability to enable its local health system to provide appropriate, co-

ordinated, effective and efficient health services as contemplated by the Act, is heavily dependent on the timely collection and analysis of accurate information. The HSP acknowledges

SRI Reporting Additional Reporting Required from the LHIN OHRS/MIS Trial Balance

Compliant – All reporting is completed as required in a timely manner.


6


Notes

that the timely provision of accurate information related to the HSP is under the HSP’s control. (b) Specific Obligations. The HSP

(i) will provide to the LHIN, or to such other entity as the LHIN may direct, in the form and within the time specified by the LHIN, the plans, reports, financial statements and other information, other than personal health information as defined in subsection 31 (5) of the CFMA, that (i) the LHIN requires for the purposes of exercising its powers and duties under this Agreement, the Act or for the purposes that are prescribed under the Act, or (ii) that may be requested under the CFMA.

(ii) will fulfil the specific reporting requirements set out in Schedule C. (iii) will ensure that all information is complete, accurate, signed on behalf of the HSP by an

authorized signing officer, and provided in a timely manner and in a form satisfactory by the LHIN; and

(iv) agrees that all information submitted to the LHIN by or on behalf of the HSP, will be deemed to have been authorized by the HSP for submission.

Submission - October 31, 2015 - January 31, 2016 - May 31, 2016 Monthly reporting to the LHIN Supplementary Reporting - November 7, 2015 - February 7, 2016 - June 7, 2016 ARR - June 30, 2016 Audited Financial Statements June 30, 2016 Declaration of Compliance June 30, 2016 FLS Report – April 30, 2016

(c) French Language Services. If the HSP is required to provide services to the public in French under the provisions of the French Language Services Act, the HSP will be required to submit a French language services report to the LHIN. If the HSP is not required to provide services to the public in French under the provisions of the French Language Service Act, it will be required to provide a report to the LHIN that outlines how the HSP addresses the needs of its local Francophone community.

French Language Services Report Or description of FLS Services if not designated

Compliant – A report is completed annually. CECCAC provides French language services.

(d) Declaration of Compliance. Within 90 days of the HSP’s fiscal year end, the Board of Directors of the HSP will issue a declaration signed by its Chair declaring that the HSP has complied with the terms of this Agreement. The form of the declaration is set out in Schedule G and may be amended from time to time through the term of this Agreement.

Also Applies to 8.1 (e) Financial Reductions

Declaration of Compliance Checklist Schedule G Signed and Returned to LHIN June 30, 2016

Compliant

8.2 Reviews. (a) During the term of this Agreement and for seven (7) years after the term of this Agreement, the

HSP agrees that the LHIN or its authorized representatives may, conduct a Review of the HSP to confirm the HSP’s fulfillment of its obligations under this Agreement. For these purposes the LHIN or its authorized representatives may, upon twenty-four hours’ Notice to the HSP and during normal business hours enter upon the HSP’s premises to:

Review Meetings Correspondence Related to Reviews



7


Notes

(i) inspect and copy any financial records, invoices and other financially-related documents, other than personal health information as defined in subsection 31(5) of the CFMA, in the possession or under the control of the HSP which relate to the Funding or otherwise to the Services; and

(ii) inspect and copy non-financial records, other than personal health information as defined in subsection 31(5) of the CFMA, in the possession or under the control of the HSP which relate to the Funding, the Services or otherwise to the performance of the HSP under this Agreement.

(b) The cost of any Review will be borne by the HSP if it (i) was made necessary because the HSP did not comply with a requirement under the Act or this Agreement; or (ii) it determines that the HSP has not fulfilled its obligations under this Agreement.

(c) To assist in respect of the rights set out in (b) above, the HSP shall disclose any information requested by the LHIN or its authorized representatives, and shall do so in a form requested by the LHIN or its authorized representatives.

(d) The HSP may not commence a proceeding for damages or otherwise against any person with respect to any act done or omitted to be done, any conclusion reached or report submitted that is done in good faith in respect of a Review required by the LHIN under the Act or this Agreement.

(e) HSP’s obligations under this paragraph will survive any termination or expiration of the Agreement

Not applicable to date

8.3 Document Retention and Record Maintenance. The HSP agrees (i) that it will retain all records (as that term is defined in FIPPA) related to the HSP’s performance

of its obligations under this Agreement for seven (7) years after the termination or expiration of the term of the Agreement. The HSP’s obligations under this paragraph will survive any termination or expiry of the Agreement;

(ii) all financial records, invoices and other financially-related documents relating to the Funding or otherwise to the Services will be kept in a manner consistent with either generally accepted accounting principles or international financial reporting standards as advised by the HSP’s auditor; and

(iii) all non-financial documents and records relating to the Funding or otherwise to the Services will be kept in a manner consistent with all Applicable Law.

Proof of retention and storage of financial documents for 7 years HSP policies related to storage of records Auditor Reports

Compliant – CECCAC has a document retention policy.

8.5. Transparency. The HSP will post a copy of this Agreement and each Compliance Declaration submitted to the LHIN during the term of this Agreement in a conspicuous and easily accessible public place at its sites of operations to which this Agreement applies and on its public website, if the HSP operates a public website. Also applies to 8.6 – Auditor General

Evidence that the M-SAA and Compliance Declaration are posted on the premises and/or HSP website.

Compliant


8


Notes

ARTICLE 9.0 - ACKNOWLEDGEMENT OF LHIN SUPPORT 9.2 Acknowledgment of Funding Support. The HSP agrees all publications will include

(i) an acknowledgment of the Funding provided by the LHIN and the government of Ontario. Prior to including an acknowledgement in any publication, the HSP will obtain the LHIN’s approval of the form of acknowledgement. The LHIN may, at its discretion, decide that an acknowledgement is not necessary; and

(ii) a statement indicating that the views expressed in the publication are the views of the HSP and do not necessarily reflect those of the LHIN or the Government of Ontario.

(iii)

Sample of Communications Materials produced by the HSP Evidence that the HSP has obtained approval from LHIN communications Department to proceed with publication.

9.2 (i) – Compliant 9.2 (ii) – Has not been required to date.

ARTICLE 10.0 – REPRESENTATIONS, WARRANTIES AND COVENANTS 10.1 General. The HSP represents, warrants and covenants that:

(i) it is, and will continue for the term of the Agreement to be, a validly existing legal entity with full power to fulfill its obligations under the Agreement;

(ii) it has the experience and expertise necessary to carry out the Services; (iii) it holds all permits, licences, consents, intellectual property rights and

authorities necessary to perform its obligations under this Agreement; (iv) all information (including information relating to any eligibility requirements for Funding) that

the HSP provided to the LHIN in support of its request for Funding was true and complete at the time the HSP provided it, and will, subject to the provision of Notice otherwise, continue to be true and complete for the term of the Agreement; and

(iv) it does, and will continue for the term of the Agreement, operate in compliance with Applicable Law and Applicable Policy, including observing where applicable, the requirements of the Corporations Act or successor legislation and the HSP's by-laws in respect of, but not limited to, the holding of board meetings, the requirements of quorum for decision-making, the maintenance of minutes for all board and committee meetings and the holding of members meetings.

(v)

By-Laws Letters Patent Board Member Bios SRI Demonstration of completion of Service volumes By Laws Board Meeting Minutes AGM Minutes Policies and Procedures Terms of Reference

Compliant as per the By-Laws of the Corporation.

10.2 Execution of Agreement. The HSP represents and warrants that: (i) it has the full power and authority to enter into the Agreement; and

By Laws Board Meeting Minutes

Compliant as per the By-Laws of the

Corporation.


9


Notes

(ii) it has taken all necessary actions to authorize the execution of the Agreement, including if the HSP is: (a) an Indian Band as defined under the Indian Act, passing a Band Council Resolution; (b) a Municipality passing a municipal by-law or resolution; or (c) a corporation passing a board resolution; authorizing the HSP to enter into the Agreement with the LHIN.

AGM Minutes Signing Authorities Policies and Procedures Terms of Reference

10.3 Governance. (a) The HSP represents warrants and covenants that it has established, and will maintain for the

period during which the Agreement is in effect, policies and procedures: (i) that set out a code of conduct and ethical responsibilities for all persons at all levels of

the HSP’s organization; (ii) to ensure the ongoing effective functioning of the HSP; (iii) for effective and appropriate decision-making; (iv) procedures for effective and prudent risk-management, including the identification and

management of potential, actual and perceived conflicts of interest; (v) for the prudent and effective management of the Funding; (vi) to monitor and ensure the accurate and timely fulfillment of the HSP’s obligations under

this Agreement and the Act; (vii) to enable the preparation, approval and delivery of all Reports required pursuant to

Article 8; and (viii) to address complaints about the provision of Services, the management or governance

of the HSP. (b) The HSP represents and warrants that

(i) The HSP has, or will have within 60 days of the execution of this Agreement, a Performance Agreement with its CEO that ties the CEO’s compensation plan to the CEO’s performance;

(ii) it will take all reasonable care to ensure that its CEO complies with the Performance Agreement;

(iii) it will enforce the HSP’s rights under the Performance Agreement; and (iv) any compensation award provided to the CEO during the term of this Agreement will be

pursuant to an evaluation of the CEO’s performance under the Performance Agreement and the CEO’s achievement of performance goals and performance improvement targets.

Policies and Procedures in Effect Evidence of CEO Performance Agreement Evidence that compensation award to the CEO is tied to the agreement.

Compliant as per Board By-laws and policies.


10


Notes

10.4 Services. The HSP represents warrants and covenants that the Services are and will continue to be provided:

HR Policies and Hiring

Compliant

(i) by persons with the expertise, professional qualifications, licensing and skills necessary to complete their respective tasks; and

(ii) in compliance with Applicable Law and Applicable Policy.

Practices Training and Certifications where required

11.3 Indemnification. The HSP hereby agrees to indemnify and hold harmless the Indemnified Parties from and against any and all liability, loss, costs, damages and expenses (including legal, expert and consultant fees), causes of action, actions, claims, demands, lawsuits or other proceedings, (collectively “Claims”), by whomever made, sustained, brought or prosecuted (including for third party bodily injury (including death), personal injury and property damage), in any way based upon, occasioned by or attributable to anything done or omitted to be done by the HSP or the HSP’s Personnel, in the course of performance of the HSP’s obligations under, or otherwise in connection with, the Agreement, unless solely caused by the negligence or wilful misconduct of an Indemnified Party. The HSP further agrees to indemnify and hold harmless the Indemnified Parties for any incidental, indirect, special or consequential damages, or any loss of use, revenue or profit, by any person, entity or organization, including without limitation the LHIN, claimed or resulting from such Claims.

Evidence of insurance provided to the LHIN and updated annually or as changes occur.

Compliant – We agree by signing the M-SAA. CECCAC has appropriate insurance in place

similar to all other CCACs.

11.4 Commercial General Liability Insurance. (a) Generally. The HSP shall protect itself from and against all claims that might arise from anything

done or omitted to be done by the HSP and the HSP’s Personnel under this Agreement and more specifically all claims that might arise from anything done or omitted to be done under this Agreement where bodily injury (including personal injury), death or property damage, including loss of use of property is caused.

Evidence of insurance provided to the LHIN and updated annually or as changes occur

Compliant – CECCAC has $15M liability insurance, Board coverage and extensive

property insurance through HIROC.

(b) Required Insurance. The HSP will put into effect and maintain, with insurers having a secure A.M. Best rating of B+ or greater, or the equivalent, for the period during which the Agreement is in effect, at its own expense Commercial General Liability Insurance, for third party bodily injury, personal injury and property damage to an inclusive limit of not less than two million dollars per occurrence and not less than two million dollars products and completed operations aggregate. The policy will include the following clauses: (i) The Indemnified Parties as additional insureds; (ii) Contractual Liability; (iii) Products and Completed Operations Liability; (iv) A valid WSIB Clearance Certificate, or Employers Liability and Voluntary

Compensation, which ever applies; (v) Tenants Legal Liability; (for premises/building leases only); (vi) Non-Owned automobile coverage with blanket contractual and physical damage

coverage for hired automobiles; and, (vii) A thirty Day written notice of cancellation.

Compliant – CECCAC uses HIROC who insures most hospitals and CCACs in Ontario.


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Notes

(c) Certificates of Insurance. The HSP will provide the LHIN with proof of the insurance required by the Agreement in the form of a valid certificate of insurance that references the Agreement and confirms the required coverage, on or before the commencement of the Agreement, and renewal replacements on or before the expiry of any such insurance.

Compliant

ARTICLE 14.0- ADDITIONAL PROVISIONS 14.1 Interpretation. In the event of a conflict or inconsistency in any provision of this Agreement, the main

body of this Agreement will govern over the Schedules. 14.2 Invalidity or Unenforceability of Any Provision. The invalidity or unenforceability of any provision of the

Agreement will not affect the validity or enforceability of any other provision of the Agreement and any invalid or unenforceable provision will be deemed to be severed.

14.3 Terms and Conditions on Any Consent. Any consent or approval that the LHIN may grant under this Agreement is subject to such terms and conditions as the LHIN may require.

14.4 Waiver. A Party may only rely on a waiver of the Party’s failure to comply with any term of the Agreement if the other Party has provided a written and signed Notice of waiver. Any waiver must refer to a specific failure to comply and will not have the effect of waiving any subsequent failures to comply.

14.5 Parties Independent. The Parties are and will at all times remain independent of each other and are not and will not represent themselves to be the agent, joint venturer, partner or employee of the other. No representations will be made or acts taken by either Party which could establish or imply any apparent relationship of agency, joint venture, partnership or employment and neither Party will be bound in any manner whatsoever by any agreements, warranties or representations made by the other Party to any other person or entity, nor with respect to any other action of the other Party.

14.7. Express Rights and Remedies Not Limited. The express rights and remedies of the LHIN are in addition to and will not limit any other rights and remedies available to the LHIN at law or in equity. For further certainty, the LHIN has not waived any provision of any applicable statute, including the Act and the CFMA, nor the right to exercise its right under these statutes at any time. 14.8 No Assignment. The HSP will not assign the Agreement or the Funding in whole or in part, directly or indirectly, without the prior written consent of the LHIN. The LHIN may assign this Agreement or any of its rights and obligations under this Agreement to any one or more of the LHINs or to the MOHLTC

14.9 Governing Law. The Agreement and the rights, obligations and relations of the Parties hereto will be governed by and construed in accordance with the laws of the LHIN of Ontario and the federal laws of Canada applicable therein. Any litigation or arbitration arising in connection with the Agreement will be conducted in Ontario unless the Parties agree in writing otherwise.

14.11 Further Assurances. The Parties agree to do or cause to be done all acts or things necessary to implement and carry into effect the Agreement to its full extent.

14.12 Amendment of Agreement. The Agreement may only be amended by a written agreement duly executed by the Parties.

Compliant


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Notes

14.13 Counterparts. The 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.

15.1 Entire Agreement. The Agreement together with the appended Schedules constitutes the entire Agreement between the Parties with respect to the subject matter contained in the Agreement and supersedes all prior oral or written representations and agreements.

Schedules Schedule C – Reports – HSP is adhering to the schedule of Reports as Outlined

Compliant

Schedule D – Directives, Guidelines and Policies Varies By Sector. Agencies to keep updated via the policy page on the MOHLTC and on the LHIN Websites. All aspects of the policies to be reviewed and followed by HSPs. Other: Community Financial Policy (2015) Local Health System Integration Act 2006 (LHSIA) Public Sector Compensation Restraint to Protect Public Services Act, 2010.

Evidence of Policies on site. Review of policies to ensure adherence to them

Procurement Policies Evidence that the policies have been followed (i.e.: back up to payables)

Compliant – The CECCAC is up to date on all current legislation and implements changes

as dictated by legislation such as Compensation Restraints and Procurement

Policies.