Central LHIN System Transformation Sub-region Planning

Community Conversations: Central April 5, 2017 Setting the Stage for Today’s Discussions

 Kick off sub-region planning & share the Central LHIN strategy;  Bring sub-region communities together to strengthen relationships through collaborative networking;  Listen and reflect upon experiences of patients and providers as they move through the system;  Create a common understanding of sub-regional attributes related to their communities and populations;  Generate greater context of sub-region needs and attributes through collaborative discussion;  Set the stage to co-create the system collectively to identify gaps in care continuity during transitions

2 Central LHIN Community Conversation North York Central Region Sub-region Agenda Time Item Presenters 1:15 to 2:00 pm Registration & Light Refreshments Sub Region Community Wall

2:00 pm Welcome & Kick Off Kim Baker Overview of the Day Chantell Tunney Central LHIN Sub-region Strategy: Transitions 2:40 pm Sharing Experiences in Care Guest Speaker: Central LHIN Resident Michael Vandenbogaerde Guest Speaker: Care Provider Dr. Sharon Levy

3:20 pm BREAK 3:30 pm Building a Foundation: Information Eugene Wong

4:00 pm Filling in the Gaps Group Work

4:55 pm Wrap Up & Next Steps Chantell Tunney

3 Integrated Health Service Plan 2016 - 2019

4 Sub-region Strategy Building momentum, leveraging local strengths and co-designing innovative approaches to care continuity

5 Population Health – What does it mean to take a Population Health approach?

Population health allows us to address the needs of the entire population, while reminding us that special attention needs to be paid to existing disparities in health. A population health approach: • Considers the upstream causes of poor health outcomes – the Social Determinants of Health • Looks at the distribution of health across populations and communities and identifies patterns (Equity) • Requires intersectoral partnerships (especially at the local level) to address barriers to good health • Takes a long-term approach

Source: Population Health & Health Care: Tai M. Huynh, University Health Network (slide 52, population health approach) – Authored on behalf of CIHI. 6 http://www.torontocentrallhin.on.ca/en/forhsps/subregions.aspx Our Growing Partnership with Public Health ’s Social Determinants of Health

7 Source: Canadian Medical Association, 2013 Patients First Framework for Strengthening the Patient Experience Stronger Links to Population and Public Health

Effective Inclusion of Integration of Population Indigenous Services and Health Based Voices in Health Greater Equity Decision- Care Planning Making Through Sub-region Planning

Timely Access to, More Consistent and Better and Accessible Integration of, Home & Primary Care Community Care 3 Central LHIN Sub-regions

Definition: A sub-region is a geographical planning region within each LHIN, outlined to better understand and address patient needs at the local level. This approach will not restrict Ontarians as they make their health care decisions.

Sub-regions will:  Enable a more focused approach to assessing the distinct health needs and service capacity in local communities:  Help to better identify health disparities and service gaps;  Assist with identifying local barriers to improvement;  Allow the community and providers to focus engagement on local circumstances and issues

Source: MOHLTC, Patients First Act Backgrounder, December 2016 5 Context: Alignment of Health Links in Sub-regions

• Central LHIN has 5 Health Links and 6 Sub-regions • Health Links and Sub-regions are not synonymous – they work together but are different strategies • Health Links and the Patients First strategy have evolved differently, and they are not synonymous • Health Links have focused on addressing the needs of 5% of the population who use a disproportionate amount of healthcare resources • Patients First (which has been informed by HL), aims to enable a more integrated system through a pop health-based approach • Maturity Assessment of 82 Health Links across province was conducted in October 2016 with HL Leads • Only 25% have been active for a maximum of 4 years • Only 46% of HL are expected to reach the third stage (Functional) of maturity by Fall 2017 (5 stages of maturity) • 16% of HL are in a formative stage and/or about to start implementation • Adoption of best practices in provider and patient engagement has started, yet only beginning to take hold 10 Central LHIN Sub-region Strategy: Greater Impact through Strong Transitions in Care

Our Co-designed Approach:

• Supports deeper collaboration between patients, families, health service providers and community partners;

• Improves care by strengthening transitions: location to location, provider to provider, service to service;

• Strengthens care by including everyone in the conversation: Patients, caregivers, primary care providers, home and community care, mental health and addictions, community care, acute sector services, long term care, allied health and other community partners;

• Tackles health inequities by focusing on population health, accessing timely data and building strong partnerships with our three public health units; • Builds and fosters interdependent networks of care across sectors and the broader system; • Transform the patient experience through a relentless focus on quality, system performance and accountability

11 The Methodology: Collective Impact Bringing Clarity to Complex Issues Collective Impact … • is an advanced form of collaboration which brings together different sectors for a common agenda to solve large complex problems • uses data and field knowledge as the foundation to determine which innovations should be scaled and which should be modified or stopped • relies on an agreement between partners to abandon their own agenda in favour of a common outcome, shared measurement and alignment of effort.

10 Central LHIN Sub-region Development Impact Statement

By September 2017, the Central LHIN stakeholder community will have co-designed an approach to working together to strengthen continuity of care during transitions for patients through the development of consistent, quality-based outcomes.

13 Principles for Shared Success Patients First, 2016 presents a platform for large-scale system change across all sectors and partners to be successful. This time of renewal will require a variety of factors necessary for success at the provincial, LHIN, sub-region and partnership levels such as:

 Renew the principles shared amongst all partners that work toward collective goals that strengthen openness and transparency;

 Diverse & flexible thought-leadership within our Central LHIN community;

 Robust stakeholder engagement & partnership planning that is authenticated through the patient and community voice;

 Timely & meaningful data for system responsiveness;

 Courage to discuss things that are not working and be willing to shift approaches for better outcomes;

 Shared accountability that puts the care of patients, families and caregivers before our historic system challenges;

 Collectively build a culture of collaboration, respect & trust

14 Building a Foundation Through Information Establishing a common understanding of sub-region data & attributes to better understand local communities and populations

15 Data Sources:

*Estimates for Population, Pop 65+ and % of Low Income: LHIN Sub-region Population Social and Economic Profile (Feb 28 2017), Health Analytics Branch, MOHLTC.

^ ED visits: ED visits crude rate. IntelliHealth Ambulatory Care, AM Case Type equal to EMG AND Fiscal Year 2014-15 AND Patient LHIN = Central LHIN. Due to data limitations, ED visits per 1000 population are available at North York level only.

~Long-Term Care (LTC) Beds: Number of licensed LTC beds within Central LHIN boundary (Internal Tracking).

16 Central LHIN Sub-regions with Neighbourhoods

17 Central LHIN Sub-regions and Neighbourhoods Northern York Western York Eastern York South Simcoe North York West North York Central Region Region Region Woodbridge South East -The Bradford 3 (195) Aurora South East (175) Thornhill South (145) Clanton Park (33) (141) Westway (6)^ Willowridge-Martingrove- South Simcoe (196) Aurora South West (176) Woodbridge East (142) Thornhill North (146) (34) Richview (7)^ Adjala-Tosorontio South Aurora Centre South West Humber Heights-Westmount South of (143) Markham West (147) Westminster-Branson (35) (197) (177) (8) Newmarket Clearmeadow North Tecumseth (198) Concord- (144) Milliken West (148) (21) West (36) /Glenway (181) ^^ Bradford 2 (199) Aurora North West (182) Richmond Hill Doncrest (157) Markham Hagerman (149) (22) Willowdale West (37)

Bradford 1 (200) Aurora Centre West (183) Richmond Hill B (158) Milliken East (150) Pelmo Park-Humberlea (23) Lansing-Westgate (38)

Alliston South (201) Aurora Centre North (184) Richmond Hill C (159) Markham East (151) (24) St.Andrew-Windfields (40)

Alliston North (202) Newmarket Armitage (185) Richmond Hill Richvale (160) Markham Central East (152) Glenfield-Jane Heights (25) Banbury- (42) Adjala-Tosorontio North Newmarket Stonehaven Around Maple (161) Cornell (153) -Roding-CFB (26) (43)^ (203)^ (186) Newmarket Quaker Maple (162) Markham Village (154) Heights (27) -Donalda (45) Hill/Haskett Park (187) Newmarket College Manor Maple Teston (163) Unionville (155) Rustic (28) Pleasant View (46) (188) Newmarket Military (189)^^ Woodbridge North (164) Buttonville (156) Maple Leaf (29) (47) Newmarket Leslie Valley Kleinburg (165) Markham Cathedral (169) Brookhaven-Amesbury (30) (48) (192) East Gwillimbury Heights Richmond Hill North West Markham 16th (170) Yorkdale-Glen Park (31) Bayview Woods-Steeles (49) (193) (166) Newmarket North West Richmond Hill North East Stouffville (171) Briar Hill - Belgravia (108) Newtonbrook East (50) (194) (167) Beechborough-Greenbrook Mount Albert (190) Richmond Hill East (168) Ballantrae-Stouffville (172) Willowdale East (51) (112) Queensville-Sharon-HL The Hill (173) Newmarket Military (189)^^ Weston (113) (52) (191)^^ Ravenshoe West (204) Richmond Hill Bathurst (174) (53)

Keswick West (205) King City (178)

Keswick South (206) Nobleton (179)

Keswick East (207) Schomberg (180) Newmarket Clearmeadow Sutton (208) /Glenway (181) ^^ Queensville-Sharon-HL Pefferlaw (209) (191)^^

Roches Point (210)

^Denotes neighbourhoods that are split between Central LHIN and other LHINs ^^Denotes neighbourhoods that are split between sub-regions. 18 Understanding the Population (by Sub-region)

North York West North York Western York Eastern York South Simcoe Northern York Central Population Characteristics (801) Central (802) Region (803) Region (804) (805) Region (806) LHIN Population Estimates (2015) 284,763 395,339 511,646 376,839 75,676 219,786 1,864,049 13,792,052 % seniors age 65+ 15.0% 15.0% 13.6% 14.9% 14.9% 13.6% 14.4% 16.0% % seniors age 75+ 7.3% 7.3% 5.6% 5.9% 6.2% 5.9% 6.3% 7.1% % Living in a rural area (2011) 0.0% 0.0% 3.2% 5.0% 31.3% 11.0% 4.1% 14.1% % Living in a large urban centre (2011) 100.0% 100.0% 95.5% 87.3% 0.0% 71.2% 88.8% N/A Socio-demographic Characteristics (% population) English Mother Tongue 47.8% 41.9% 48.3% 45.8% 84.5% 81.9% 51.7% 70.3% French Mother Tongue 1.0% 1.6% 1.1% 1.1% 1.6% 1.6% 1.2% 4.4% No knowledge of English or French 6.4% 5.1% 4.3% 7.6% 0.9% 1.0% 4.9% 2.4% Immigrants 56.1% 58.6% 48.9% 54.7% 15.4% 20.7% 48.6% 28.6% Recent immigrants (within 5 years) 8.6% 12.5% 5.0% 5.7% 0.8% 1.9% 6.8% 3.8% Visible minorities 58.8% 54.2% 39.8% 67.1% 5.6% 14.3% 46.9% 25.9% Indigenous Identity 0.2% 0.1% 0.2% 0.2% 1.4% 1.3% 0.4% 2.3% Labour force participation rate (age 15+) 59.9% 61.8% 69.2% 65.3% 70.2% 72.9% 65.8% 52.6% Unemployment rate (age 15+) (2005) 5.9% 5.0% 4.3% 5.1% 4.7% 5.6% 5.0% 8.3% Without certificate/degree/diploma (age 25-64) 19.5% 3.7% 7.8% 9.7% 14.6% 9.2% 9.5% 10.7% Completed post- (age 25-64) 52.0% 79.4% 72.7% 69.6% 55.3% 66.3% 69.0% 64.8% Living in low-income 21.8% 20.2% 10.6% 12.7% 7.4% 8.5% 14.5% 13.8%

Source(s): LHIN Sub-region Population Social and Economic Profile (Feb 28 2017), HAB, MOHLTC.

19 Health Service Providers (HSPs) in Central LHIN The map depicts the head office and satellite locations of Central LHIN funded HSPs.

Note that HSPs with offices in a particular region often provide services for people in other regions.

Central LHIN funds a total of 96 HSPs through 109 accountability agreements.

Source: ~CCAC Clinics, Central CCAC December 2016 *HSP Locations: Central LHIN Accountability Agreements, Central LHIN contact information CCAC Hospital Physicians per 100,000 Sub-region CHC* MH&A* CSS* Hospital* LTC* Family Physicians ** 2016 and HSP Survey (January 2015); The table Clinics~ (Private)* Population*** does not include West Park Healthcare Centre. Western York Region 2 1 5 30 1 11 499 98 ** Family physicians, Ontario GP/FP List (2016- 06-10), prepared by Health Analytics Branch, North York Central 2 9 27 1 8 1 456 115 MOHLTC. North York West 1 1 10 27 1 9 299 105 *** Physicians per 100,000 population: Provincial average is 107; National average is Northern York Region 1 13 22 1 8 215 98 114. Canadian Medical Association (2014): Eastern York Region 1 8 21 1 7 1 267 71 https://www.cma.ca/Assets/assets- South Simcoe 1 6 2 1 3 55 73 library/document/en/advocacy/14-FP_per_pop.pdf Out of Boundary 6 27 20 North York Central (NYC) – Population Overview

21 North York Central Neighbourhoods

Total Population # Neighbourhood Name (2011 Census) 1 Banbury-Don Mills 26,918 2 Bathurst Manor 15,434 3 Bayview Village 17,671 4 Bayview Woods-Steeles 13,530 5 Clanton Park 14,612 6 Don Valley Village 26,739 7 Henry Farm 11,333 8 Hillcrest Village 17,656 9 Lansing-Westgate 14,642 10 Newtonbrook East 16,423 11 Newtonbrook West 23,052 12 Parkwoods-Donalda 34,617 13 Pleasant View 16,144 14 St.Andrew-Windfields 17,958 15 Victoria Village 17,182 16 Westminster-Branson 25,446 17 Willowdale East 45,041 18 Willowdale West 15,004

North York Central has 18 neighbourhoods. The Victoria Village neighbourhood is split between Central LHIN and Central LHIN.

Source: http://www.ontariohealthprofiles.ca 22 North York Central Health Service Provider List North York Central Asset Map Community Care Access Centre (CCAC) CCAC Clinic at North York General &Fairview Health Centre Service provider organizations (Nursing, PSW, OT, PT, Social Work, Speech Language, Dietician) Mental Health and Additions (MH&A) Bayview Community Services Chai-Tikvah Foundation North York General Hospital Toronto North Support Services Primary Care Providers Don Mills Family Health Team (6 FHT Physicians) North York Family Health Team (74 FHT Physicians) 456 Primary care physicians (includes FHT physicians) Community Support Services (CSS) Access Independent Living Services Aphasia Institute Bernard Betel Centre for Creative Living Better Living At Thompson House Better Living Health and Community Services Canadian National Institute for the Blind - York (CNIB) Carefirst Senior and Community Services Association Circle of Home Care Services (Toronto) City of Toronto Community Head Injury Resource Services of Toronto (CHIRS) Lumacare Services North York Seniors Centre North Yorkers for Disabled Persons Inc Yee Hong Centre - Markham North York Central has 2 hospitals (including one private), 456 Hospital North York General Hospital primary care physicians, 2 CCAC clinics, 8 LTC homes, 9 Don Mills Surgical Unit Ltd. (Private) community MH&A agency service locations and 27 CSS agency Long Term Care (LTC) locations (includes head office and satellite locations). Better Living At Thompson House Chartwell Gibson Long Term Care Residence Each agency may have multiple service locations in the sub-region. Cheltenham Care Community City of Toronto, Long-Term Care Homes & Services – Carefree Lodge Source: CCAC Clinics, Central CCAC, December 2016; HSP Locations, Central LHIN Accountability City of Toronto, Long-Term Care Homes & Services – Cummer Lodge Extendicare (Canada) Inc - Bayview Agreements, and HSP Survey (January 2015); The table does not include West Park Healthcare Centre. Seniors’ Health Centre Valleyview Residence 23 Primary Care Physicians by Sub-region (2016)

Total Number of Primary Care Physicians Practicing in Central LHIN 1,791 Only 7% of Central LHIN Primary Care physicians (122 of 1,791) are in Family Health Teams (FHTs)

Physicians per 100,000 Population

Provincial Average: 107

All Central LHIN sub-regions except for North York Central, have a primary care physician to population ratio that is lower than the provincial average.

Source(s): ** Family physicians, Ontario GP/FP List (2016), prepared by Health Analytics Branch, MOHLTC. *** Physicians per 100,000 population: Central LHIN population, LHIN Sub-region Population Social and Economic Profile (Feb 28 2017), HAB, MOHLTC; the provincial average, Canadian Medical Association: https://www.cma.ca/Assets/assets-library/document/en/advocacy/14-FP_per_pop.pdf.

24 Percent of People 19+ with No Primary Care Visits in Central LHIN

North York Central 15 of 18 neighbourhoods have a higher than Central LHIN average proportion of people 19+ with no primary care visits (>8.5% LHIN).

*Primary care physicians practicing in the Central LHIN: FHO – 391 FHT – 122 FHG - 571 FFS/CCM - 707

* Source: Ontario GP/FP List (2016-06-10), prepared by Health Analytics Branch, MOHLTC.

25 North York Central – Seniors Population Seniors Aged 65 and over, 2011 Seniors Aged 65 and over, living alone, 2011

North York Central has the highest percentage of seniors aged 65+ % of Total population in private households that in the LHIN (15.0% vs 14.4% - LHIN, 16.0% - Ontario). ** are 65+, living alone, Both sexes, 2011 Bayview Woods-Steeles has the highest proportion of seniors in 40.0 the NYC neighbourhoods (23.7%) * 35.0 30.0 25.0 20.0 16 of 18 neighbourhoods in North York Central have a higher proportion 15.0 of seniors living alone above the LHIN average. (18.7% - LHIN, 24.4% - 10.0 5.0

Ontario)* 0.0 % of % TotalPopulation Neighbourhoods Victoria Village and Willowdale West have the highest proportion of seniors living alone in NYR neighborhoods (>34.0%).*

Source(s): *http://www.ontariohealthprofiles.ca; ** LHIN Sub-region Population Social and Economic Profile (Feb 28 2017), HAB, MOHLTC 26 North York Central – Diversity Top 3 Languages*** for Non-English speaking Households by Neighbourhood (2011)

Nearly half of North York Central’s population Neighbourhood Name #1 #2 #3 are visible minorities. (54.2% vs 46.9%- Clanton Park Tagalog (Pilipino, Filipino) Russian Italian LHIN, 25.9%-Ontario).* Bathurst Manor Russian Tagalog (Pilipino, Filipino) Italian Westminster-Branson Russian Tagalog (Pilipino, Filipino) Korean Newtonbrook West Russian Korean Persian (Farsi) Higher than LHIN average “proportion of Willowdale West Persian (Farsi) Korean Russian population with no knowledge of English or Lansing-Westgate Russian Persian (Farsi) Korean St.Andrew-Windfields Mandarin Korean Persian (Farsi) French”. (4.3% vs. 4.9% - LHIN).** Banbury-Don Mills Chinese, n.o.s. ** Mandarin Persian (Farsi) Victoria Village Arabic Persian (Farsi) Tamil Parkwoods-Donalda Persian (Farsi) Spanish Mandarin The most common languages spoken at Pleasant View Mandarin Chinese, n.o.s. ** Cantonese home other than English are Chinese Don Valley Village Mandarin Chinese, n.o.s. ** Persian (Farsi) (including Cantonese and Mandarin), Hillcrest Village Mandarin Chinese, n.o.s. ** Cantonese Bayview Woods-Steeles Chinese, n.o.s. ** Mandarin Cantonese Persian/Farsi, and Korean. Newtonbrook East Persian (Farsi) Korean Cantonese Willowdale East Persian (Farsi) Korean Mandarin Bayview Village Persian (Farsi) Chinese, n.o.s. ** Cantonese Henry Farm Mandarin Persian (Farsi) Chinese, n.o.s. **

Source(s): * Visible Minority , Indigenous Identity (Aboriginal Identity), Visible Minority* Indigenous Identity* LHIN Sub-region Population Social and Economic Profile (Feb 28 2017), HAB, MOHLTC; ** Top 3 languages, Neighbourhood level data, 54.2% 530 (8.5%) http://www.ontariohealthprofiles.ca/. Central LHIN Ontario Central LHIN 46.9% 25.9% 6,215

27 NYC – Lone-Parent Families and Low-Income

Lone Parent Families in Central LHIN North York Central has a high proportion of lone- parent families compared to the LHIN (19.2% vs 16.9%-LHIN and 16.7%-Ontario).*

Victoria Village and Parkwoods-Donalda neighbourhoods have the highest proportion of lone-parent families in the region (>25%).*

North York Central has a higher proportion % who are living below the low-income measure, after tax (by of the population living below the low- Sub-region) income cut-off in the LHIN. (20.2% vs North York West 21.8% 14.5%-LHIN, 13.8%-Ontario)** North York Central 20.2% Central 14.5% Ontario 13.8% Eastern York Region 12.7% Western York Region 10.6% Source(s): *http://www.ontariohealthprofiles.ca; ** LHIN Sub-region Northern York Region 8.5% Population Social and Economic Profile (Feb 28 2017), HAB, MOHLTC South Simcoe 7.4%

28 Health Links vs. Sub-regions

Central LHIN Health Link Central LHIN Sub-region

South Simcoe and Northern York Region South Simcoe (SS) Health Link (SSNYR) Northern York Region (NYR)

South West York Region Health Link Western York Region (WYR)

South Region Health Link Eastern York Region (EYR)

North York Central Health Link North York Central (NYC)

North York West Health Link North York West (NYW)

29 NYC – Adult Health & Disease Prevalence

South Simcoe and South West York South East York Northern York Central North York West Central Prevalence Region Health Region Health Ontario Region Health Health Link Health Link LHIN Link Link Link Diabetes 10.7 (L) 12.3 (NS) 13.1 (H) 11.0 (L) 15.6 (H) 12.3 12.1

Asthma 16.2 (H) 12.6 (NS) 11.7 (L) 9.7 (L) 14.2 (H) 12.5 13.5

High Blood Pressure 25.9 (H) 24.2 (L) 25.5 (NS) 23.8 (L) 29.0 (H) 25.3 26.4

COPD 9.5 (H) 6.3 (L) 5.6 (L) 7.3 (NS) 9.7 (H) 7.4 10.4 COPD - Chronic Obstructive Pulmonary Disease Lower is better

Higher than the LHIN rate (Significantly Different) Lower than the LHIN rate (Significantly Different)

North York Central Health Link has better or comparable rates to the LHIN and provincial rates in the 4 disease prevalence indicators.

Source: www.ontariohealthprofiles.ca. CRICH/ICES defined prevalence rate as High (H) or Low (L) as: chances are at least 19 in 20 that the Health Link rate is higher (H) or lower (L) than the LHIN rate. Rates marked as not significantly higher or lower than the LHIN rate = NS 30 NYC – Prevention & Screening

South Simcoe and South West York South East York North York Central North York West Prevention and Screening Northern York Central LHIN Ontario Region Health Link Region Health Link Health Link Health Link Region Health Link

Mammograms 65.5% ( L) 68.3% (H) 70.6% (H) 62.2% ( L) 61.5% ( L) 66.1% 63.2%

Pap Smears 61.2% ( H) 59.6% ( H) 58% ( H) 51.4% ( L) 52.5% ( L) 56.5% 55.1%

Any Colorectal Cancer Screening 65.0% ( L) 67.6% ( H) 70.5% ( H) 64.4% ( L) 57.8% ( L) 65.8% 58.9%

Colonoscopy 48.2% ( H) 48.7% ( H) 47.1% ( H) 43.3% ( L) 35.1% ( L) 45.4% 37.0%

Fecal Occult Blood Test 31.9% ( L) 36.1% ( L) 43.7% ( H) 36.6% (NS) 34.2% ( L) 36.9% 35.4% Higher is better Higher than the LHIN rate (Significantly Different) Lower than the LHIN rate (Significantly Different) North York Central Health Link has lower or comparable rates to LHIN and provincial rates in all prevention/screening indicators.

Source: www.ontariohealthprofiles.ca. CRICH/ICES defined screening rates as High (H) or Low (L) as: chances are at least 19 in 20 that the Health Link rate is higher (H) or lower (L) than the LHIN rate. Rates marked as not significant = NS

31 NYC – Mental Health & Addictions Challenges

Mental Health Physician Visits % of repeat ED visits within 30 days* (Mental Health & Substance Abuse by Hospital):

Humber River Regional Markham Stouffville North York General Southlake Regional Stevenson Memorial Mackenzie

LHIN Ontario

33.0%

32.5%

27.1%

26.4%

24.2%

23.2%

20.8%

20.4%

20.2%

20.1%

20.0%

18.4%

17.9%

17.1%

16.9% 11.2%

MENTAL HEALTH SUBSTANCE ABUSE NYC has a higher prevalence of mental health visits North York Central (North York General) has: for seniors- age 65+ versus LHIN (9.0 vs 8.6-LHIN). - Lower % of repeat ED visits within 30 days for Mental Health NYC has a lower rate of mental health visits for adults, compared to LHIN and provincial performance. (17.1% vs. 18.4%- ages 20+ (7.7 vs. 8.3-LHIN, 9.7-Ontario).** LHIN, 20.1%-Ontario) Victoria Village has the highest rate of adult mental - Lower % of repeat ED visits within 30 days for Substance health visits (age 20+) in NYR (10.9).** Abuse compared to LHIN and provincial performance. (26.4% vs. 27.1%-LHIN, 33.0%-Ontario) **Mental health conditions are defined by the occurrence of a doctor`s visit for a Source: *Stocktake report, Q1 2015/16 to Q4 2015/16. –Supplemental - Rep. Visit by Hosp. symptom related to mental health. Source: http://www.ontariohealthprofiles.ca Results of multi-site facilities including UCCs are aggregated to the hospital. (adult health and disease – chronic conditions) 32 NYC – Health Care Utilization Rate of ED Visits (per 1000 population) NYC has a lower rate of ED visits (per 1000 population) compared to the LHIN rate (294.8 vs 323.2-LHIN, 509.4-Ontario)**. The top 3 neighbourhoods in the region with the highest rate of ED visits are Bathurst Manor, Victoria Village, and Westminster-Branson. .

Acute separation rate per 1,000 population by Health Link region South East York Region 51.77 NYC has a higher acute separation rate per 1,000 population compared to the LHIN but lower than South West York Region 54.47 provincial rate (64.2 vs 60.7-LHIN and 72.9- Ontario). North York Central 64.19

South Simcoe and Northern York 67.31 Region

North York West 72.69

Source(s): **http://www.ontariohealthprofiles.ca – Age Standardized, All Ages 0+ ; ***Population and Equity analysis (2016-05), Health Analytics Branch, MOHLTC.

22 Filling in the Gaps ~ Group Work

Bringing data to life through experience and conversation

34 Group Discussion:

1. How does the data and attributes related to this sub-region reflect in your ability to provide care to patients and clients?

2. In your experience, how do these attributes effect the quality of patient care?

3. What people, places and programs are currently making a difference to address challenges in the North York Central Sub-region?

4. What local issues, data and other considerations are we missing that needs to be captured or discussed as we strengthen local patient care?

Please be sure to fill out the template provided. This will be used to develop a Sub-region Summary Report.

35 What’s Next?

 Refining sub-region specific Data Resources for providers and partners to use for local planning  Creating Community Conversation Summary Reports: • One for each sub-region • One capturing LHIN-wide themes  All documents and resources posted to the Central LHIN website  Continue to coordinate local collaborative events (see schedule) and keep our discussions going!  Continue to develop a consistent approach to implement sub-region based initiatives  Begin to develop a Collective Impact and Sub-region Implementation Toolkit for local provider and partner use  Plan for a Learning Forum in Fall 2017

36 37