Ontario Health Team in Mississauga Information Session August 23, 2019 Agenda for this meeting • Provide a summary of where we are now in the planning process • Offer an introduction to our population and its demographics • Describe where we are in the planning process and our approach to engagement • Share information about next steps and how individuals can stay involved 2 Ontario Health Teams The vision for Ontario Health Teams (OHTs) as set out by the Ministry of Health and Long-Term Care (MOHLTC) is to create integrated care systems in Ontario to improve health outcomes, patient and provider experience, and value. The OHTs will consist of groups of providers and organizations that are clinically and fiscally accountable for delivering a full and coordinated continuum of care to a defined geographic population. OHTs will: Provide a full and coordinated continuum of care for an attributed population within a geographic region Offer patients 24/7 access to coordination of care and system navigation services and work to ensure patients experience seamless transitions throughout their care journey Be measured, report on and improve performance across a standardized framework linked to the ‘Quadruple Aim’: better patient and population health outcomes; better patient, family and caregiver experience; better provider experience; and better value Operate within a single, clear accountability framework Be funded through an integrated funding envelope Reinvest into front line care Improve access to secure digital tools, including online health records and virtual care options for patients – a 21st century approach to health care 3 Where we are now We are here Assessment Process Dates Open call for self-assessments April 3, 2019 Deadline to submit self-assessments May 15, 2019 Selected groups will be invited to submit a full July 18, 2019 application Deadline to submit full applications October 9, 2019 Announce OHT Candidates Fall 2019 Deadline for Second Round of self-assessments December 4, 2019 According to Ministry guidance, both “In Development” and “OHT Candidates” will: • help demonstrate the impact of the model on quality of care, patient and provider experience, and cost, and will provide important lessons for implementing the model across the rest of the province • set course for system-wide transformation • prioritized for future investments and receive incentives based on performance • have access to tailored supports *Note: Ministry site visit has not yet taken place and will depend on Ministry timelines 4 Who we are Our core partners for the application Primary Care Hospital Home Care Community Credit Valley FHT Trillium Health Partners Home care* Metamorphosis Network of 45 Summerville FHT Agencies CarePoint Health Our committed community partners Representing diverse sectors, including mental health and addictions, palliative and long-term care and social services AbleLiving Services Dufferin-Peel Catholic District Nucleus Independent Living ProResp TEACH - Centre for Innovation in School Board Alzheimer Society of Peel Nurse Next Door Region of Peel Peer Support East Mississauga Midwives AstraZeneca Canada Inc Ontario Telemedicine Network Registered Nurses Association of United way of Peel Region ErinoakKids Ontario Bayshore HealthCare Peel Addiction Assessment and University of Toronto Mississauga Heart House Hospice Referral Centre S.R.T. Med Staff Beacon The Victorian Order of Nurses Seniors Life Enhancement Centres Peel District School Board Saint Elizabeth Health Centre Canes Community Care West Park Health Centre Links2Care Peel Public Health Schlegel Villages CBI Health Group Yee Hong Centre March of Dimes Canada Punjabi Community Health Sheridan College City of Mississauga YMCA of Greater Toronto Midwives of Mississauga Services Sienna Senior Living Closing the Gap Healthcare Group Mississauga Board of Trade Peel Regional Police Spectrum Dixie Bloor Neighbourhood Centre Mississauga Halton Palliative Care Peel Senior Link Dorothy Ley Hospice Network *Over time, we envision home care as a core partner and service as part of the OHT. We will 5 work in alignment with government direction to support the evolution of these services The Mississauga Ontario Health Team: Interim governance model Interim Governing Project Management Office Strategy, Design and Sponsor: Michelle DiEmanuele Oversight Council Exec Lead: Mira Backo-Shannon Chair: Michelle DiEmanuele Lead: Georgia Whitehead OHT Implementation Planning and Implementation Working Group Chair: Mira Backo-Shannon Integrated Planning and Engagement and Design Design Councils Lead: Bonnie Scott 6 Caring for our community 65% of our population are immigrants; 50% are visible minorities and Ours is a large, diverse community 50% report a first language other than English or French* with many different cultural and ethnic backgrounds. 15% of our population are seniors and more than 6.4% are over 75 This community is experiencing years of age; 22% are children growth in populations across all ages, as well as increases in significant Over 22% are living with at least one chronic condition, but this multimorbidity and social inequity. community currently has the fewest interprofessional primary care teams in Ontario, no youth mental health beds, the fewest long-term In many cases, our health care care beds infrastructure is stretched beyond capacity. In 1980, only 2% of neighbourhoods were low income, while today, low- and very low-income neighbourhoods represent 51% of the community We also have a diversity of strong community partners who have a history of collaboration and working together. Through an OHT, there is an opportunity for providers to improve the health of our population by providing high quality, integrated care across the continuum, from prenatal care to birth to end of life. 7 * Population demographics based on initial population attribution methodology; to be updated as understanding of our attributed population evolves Who is our population? Understanding our Population People who are rostered with physicians The Ministry uses an attribution 4 who are not located in methodology that is based on Mississauga but refer physician referral networks. Based their patients to THP on Ministry methods, groups 1, 2 (patients may or may and 4 are part of the population this 1 not live here) OHT will be accountable for at People who live in x maturity. Mississauga and 2 receive care here 5 People who live in We are also considering groups 3, Mississauga but do not 5 and 6 as we plan to ensure that People who are have an OHIP card we are taking a holistic view of the rostered to physicians people who live in the region. in Mississauga but do not live in Mississauga x 3 6 People who live in A few facts about our population: Mississauga but are People who live in not rostered • According to the Ministry’s Mississauga but anywhere receive care methodology, we will be elsewhere accountable for approximately 878,000 people at maturity • About 50% of those people live in Mississauga and are rostered with primary care physicians * As we work with the Ministry to further understand our population, this will continue to evolve; located here 8 we will keep you informed as this develops Understanding our population demographics Age Distribution 40.0 Mississauga Ontario 35.0 30.0 OHT 25.0 Immigrant 29.3% 15.6% 20.0 15.0 10.0 Recent immigrant 3.8% 2.3% 5.0 0.0 Refugee 4% 3% 0-19 20-44 45-64 65-74 75+ Mississauga OHT Ontario Immigration - World Region Material Deprivation Quintile 30.0 25.0 20.0 15.0 10.0 5.0 Africa & Middle East Americas 0.0 Asia & Pacific Europe Q1 (Least Q2 Q3 Q4 Q5 (Most United States of America Deprived) Deprived) Mississauga OHT Ontario 9 Data sources: Immigration, Refugees and Citizenship Canada Open Data; All data are proportional estimates and will depend on further defining population Selected risk factors among people living in Mississauga Food insecure Moderate drinker Heavy drinker Inactive Physical Moderate Activity Active Former smoker Current smoker Obese Overweight BMI Normal weight Underweight 0.0 10.0 20.0 30.0 40.0 50.0 60.0 South West Mississauga North West Mississauga East Mississauga 10 Data sources: Canadian Community Health Survey, 2013-14; Data are based on Mississauga geography and not on the complete attributable population Community and life stress in Mississauga Poor/fair self-rated mental health Dissatisfied with life Self-reported consultation with a mental health professional in the last year Very weak sense of community belonging High life stress 0.0 5.0 10.0 15.0 20.0 25.0 30.0 All South West Mississauga North West Mississauga East Mississauga 11 Data sources: Canadian Community Health Survey, 2013-14; Data are based on Mississauga geography and not on the complete attributable population How our population uses health care Population Risk Adjustment Grouping (PRAGs) for Rostered in Mississauga 12 - Minor Acute 16 - Health System Non-User 13 - Minor Chronic 15 - Health System User With No Health Conditions 08 - Moderate Chronic Collapsed Aggregated 07 - Moderate Acute Diagnostic Groups (ADGs) 10 - Other Mental Health Acute minor Acute major 03 - Major Chronic Likely to Recur 11 - Obstetrics Chronic medical: stable Preventive/Administrative These graphs show 02 - Major Acute Psychosocial the burden and 05 - Major Mental Health Chronic medical: unstable weight of care 09 - Other Cancer Chronic Specialty: Unstable conditions for our Eye/Dental population, and can 06 - Major Cancer Asthma be used for future 14 - Healthy