South West Local Health Integration Network (LHIN) announces $9.6 million in new funding to support key health system priorities

LONDON, ON, Sept. 21, 2015 /CNW/ - The South West LHIN is providing $9.6 million in new funding in 2015-16 to improve health care for people in our communities.

The South West LHIN will contribute $5,089,300 in new base funding to support investments in the community sector, and another $4,538,409 in one-time funding through the LHIN Urgent Priorities Fund. Investments include a 1 per cent base increase to most community sector health service providers, as well as targeted investments into specific priority programs and projects.

The LHIN has engaged with health service providers throughout the investment planning process, gathering important input about investment options. Funding priorities are focused on targeted investments with the greatest potential impact on achieving the goals in our Integrated Health Service Plan.

Funding is aimed at improving access to family care, enhancing coordination and transitions of care, as well as driving safety through evidence-based practices, and ensuring value for money. Investments will work to:

  • Enhance support for assisted living hubs, a program focused on a more coordinated delivery model for assisted living services
  • Improve hospice palliative care outreach with the aim of enhancing support for palliative patients
  • Enhance stroke care
  • Support the advancement of Behavioural Supports Ontario to support older adults with behavioural issues
  • Develop and roll-out a coordinated access model for Diabetes Education Programs
  • Advance Health Links, a provincial initiative working to coordinate care for high needs patients
  • Enhance support for adults living with chronic mechanical ventilation
  • Advance technological solutions to improve care for patients

A complete list of investments with descriptions is available in Appendix A.

"Part of our government's Patients First strategy is about ensuring that the highest quality care is delivered in a way that puts patients' needs at the centre of everything we do as health care workers.  By investing in important local programs that help people and patients stay in their home and community for as long as possible, we are working to improve the patient experience as well as patient outcomes." – Dr. Eric Hoskins, Minister of Health and Long-Term Care

"In providing both base funding for community sector health service providers, as well as targeted investments, we are ensuring that providers have the resources they need to improve access to essential health care services in the South West LHIN." – Jeff Low, Board Chair, South West LHIN

"These investments will assist our population to access the health services they need to allow them to live healthy and independently in their own homes and communities for as long as possible." – Michael Barrett, CEO, South West LHIN.

2015-16 Priorities for Investment Plan



Scorecard Outcomes impacted

Health Service Providers Involved

2015/16 Funding Investment

One-time Funding




Strategic Direction: Improve Coordination and Transitions of Care


Huron Perth Coordination & Transitions of Care: Sustainability & Spread
Support the sustainability and spread of the care planning model for the ongoing sustainability of care planning and spread enhanced information technology for the model

Care planning and common intake across all Community Support Service partner agencies implemented

Reduce Emergency Room revisit rates within 7 days                   
Reduce hospital readmission rates with 30 days for selected Case Mix Groups                                

ONECARE and all other community support agencies in Huron Perth





Assisted Living Hubs Unmet Needs 
Enhance support for existing phase 1 communities and expand the Assisted Living/Supportive Housing hub model to Phase 2 communities in the South West LHIN to address up to 5% unmet need for high needs clients including frail seniors and adults with disabilities

Improve access to assisted living services for high risk seniors and adults with disabilities - up to 5% unmet need will be met in each of the identified communities (decreasing wait times for access to services)

Reduce Alternate Level of Care rate

Reduce Emergency Room revisit rates within 7 days    

Cheshire, VON Grey Bruce, VON Middlesex Elgin, Red Cross, Dale Brain Injury Services, Ingersoll Services for Seniors, Tillsonburg Multi-Service Centre, ONECARE, Spruce Lodge




Hospice Palliative Care Outreach Expansion Project
Spreading the Hospice Palliative Care Outreach Model into Oxford and Elgin

Enhanced ability of teams to support patients dying in their place of choice and in reduce the overall number of deaths of palliative patients in a hospital setting

Reduce Emergency Room revisit rates within 7 days  Reduce Alternate Level of Care rate

South West CCAC in collaboration with contracted service providers, local Community Support Services agencies, primary care, Residential Hospice (Woodstock & London), Long Term Care Homes, hospitals, spiritual care and bereavement providers.




Community Stroke Rehabilitative Outreach Program
Enhance capacity of Community Stroke Rehab teams to provide services to more people in a timely way

Reduced wait times and wait lists for community programs

Reduce hospital readmission rate within 30 days for selected Case Mix Groups

Huron Perth Health Care Alliance, St. Joseph's Health Centre, Grey Bruce Health Services



Mental Health and Addictions Crisis Centre
To support/enhance the operations of the Mental Health and Addictions Crisis Centre 

Improved care coordination and system navigation for people who are experiencing distress and symptoms of a mental health condition that require triage, assessment and treatment                                                                             

Reduce Emergency Room revisits rates with 7 days

Canadian Mental Health Association Middlesex, Addiction Services Thames Valley, London Health Sciences, Mission Services



Aboriginal Hospice Palliative Care Planning Readiness and Needs Assessment
Aligned to a provincial model, these assessments will support the development of an Aboriginal approach to Hospice Palliative Care

Complete assessments and develop Indigenous specific care pathways and Aboriginal roadmap to support the Hospice Palliative Care Strategy for the LHIN                                           

Reduce Alternate Level of Care rate

Aboriginal Health Committee will  provide oversight
Southwest Ontario Aboriginal health Access Centre




Behavioural Supports Ontario - Memory Clinics
Support training of team to run memory clinics through primary care settings

Increased capacity to provide memory clinics across the  LHIN

Reduce Alternate Level of Care rate

St. Joseph's Health Centre, Alzheimer Societies, Primary Care



Diabetes Coordinated Access Development and roll-out of a coordinated access model for Diabetes Education Programs in the South West LHIN

People with diabetes have timely, equitable access to diabetes education

Reduce hospital readmission rate within 30 days for selected Case Mix Groups

London InterCommunity Health Centre with potential spread to other health service providers with diabetes services




Home and Community Care Policy Implementation Support the implementation of Home and Community Care policy changes and to implement recommendations related to the long-term viability and success of the Community Support Services collaborative assessment and referral model

Improved integration and coordination of Personal Support Services delivered by CCAC and Community Support Services agencies across the South West

Reduced Alternate Level of Care rate

Participation House, ONECARE Home & Community Support Services, CCAC



Health Links
Development of a business plan for initiating of Health Links in Oxford and Elgin counties. This project aims to improve the health of the small portion of the population, with complex healthcare needs, who are using a high proportion of healthcare resources

Business plan approved and ready for implementation

Reduce Emergency Room revisit rates within 7 days                    
Reduce hospital readmission rates with 30 days for selected Case Mix Groups                                 Increase percent of clients seeing family health care provider within 7 days of discharge                          

Canadian Mental Health Association Oxford and Woodstock and Area Community Health Centre (Oxford), East Elgin Family Health Team (Elgin)



Hospice Palliative Care Analyst
To ensure sustainability of the metrics and performance management of the Integrated Hospice Palliative Care System of Care

Continued monitoring of regional and sub-LHIN area Hospice Palliative Care-specific scorecards                       

Reduce Alternate Level of Care rate
Reduce Emergency Room revisit rates within 7 days




Staged Screening and Assessment Process training for Addictions
Addiction services staff will be trained  to implement evidence based, standardized assessment tools

Expert screeners will implement a set of standardized, evidence-based tools and protocols that are integrated into the existing Mental Health and Addictions system of care

Reduce Emergency Room revisits rates within 7 days

Addiction Services Thames Valley, Choices for Change, HopeGreyBruce



Rehabilitative Care Alliance
Working towards implementation of system-level standardization of rehabilitation definitions, eligibility criteria and resourcing. Developing an Evidence Informed Rehabilitation Capacity Plan to help support directional recommendations regarding system level rehabilitation resources

LHIN wide review of current rehabilitative care resources relative to the Rehabilitative Care Alliance's Bedded and Community Definitions Frameworks
Development of an Evidence Informed Bedded Rehabilitation Capacity Plan and recommendations to support the right care provided in the right space

Reduce Alternate Level of Care rates

Rehabilitative Care Committee members, all hospitals with rehab/Complex Continuing Care beds, Long Term Care facilities with convalescent care beds, any other LHIN and/or Ministry funded community providers of rehab services




Stroke Clinical Services Planning - Phase 1  Implementation of Directional Recommendations                                       Implementation and evaluation of the future state of stroke care directional recommendations approved by the South West LHIN Board of Directors

Best practice stroke care provided to stroke patients requiring admission to hospital through the realignment of stroke services from 28 hospitals to 7 designated stroke centres.
Evaluation framework developed, implemented including recommendations for sustainability / ongoing monitoring of system change

Reduce hospital readmission rate within 30 days for selected Case Mix Groups

London Health Sciences Centre, St. Joseph's Health Centre, Huron Perth Healthcare Alliance, Grey Bruce Health Services, St. Thomas General Hospital, Woodstock Hospital, Alexander Marine General Hospital, CCAC, Emergency Medical Services




Stroke Clinical Services Planning - Phase 2: Stroke Current State Assessment and Best Practice Recommendations for Post Hospital Care
Create future state directional recommendations addressing gaps in secondary stroke prevention, outpatient/community rehabilitation, and community support services that will achieve improved patient experiences, system efficiencies and ensure that more stroke survivors live successfully at home

Capacity Assessment and best practice recommendations for current Secondary Stroke Prevention Clinic model and resource needs, Community Stroke Rehabilitation Teams model and resource needs to meet the population as well as recommendations for other community support services. 

Reduce Alternate Level of Care rates

London Health Sciences Centre, St. Joseph's Health Centre, Huron Perth Healthcare Alliance, Grey Bruce Health Services, St. Thomas Elgin General Hospital, Woodstock General Hospital, CCAC, Community Health Centres, Long Term Care Homes




Telemedicine Nursing Initiative
To support the clinical costs associated with Nurse Practitioner requirements in the South planning area of the LHIN

Support the implementation of telemedicine services across the health care sector
Support the government's commitment to preventing illness and injury, improving access to health care, responding to the needs of diverse communities and providing high quality care, everywhere.

Reduce Emergency Room revisits within 7 days

Addiction Services Thames Valley, Canadian Mental Health Association Middlesex, London Health Sciences Centre


Strategic Direction: Increase the value of our health care system


Home First/Intensive Hospital to Home  Increasing the number of patients being served through Home First refresh and enhancing services to existing patients to ensure that they are getting the level of care they require through the Intensive Hospital to Home program

Continuing to enhance Home First and  Intensive Hospital to Home care plans to maintain reductions in Alternate Level of Care, Emergency Department visits and hospital admissions                                                                                                

Reduce Alternate Level of Care rate Reduce Emergency Room revisits rates within 7 days

CCAC, all hospitals, and assisted living/supportive housing/adult day program providers in the LHIN



Phase 2: Enhancements to the Regional System of Health and Supportive Care serving Adults Living with Chronic Mechanical Ventilation in the South West LHIN
Understand and develop strategies to address the challenges to transition and support people living with tracheotomies and chronic mechanical ventilation to Long Term Care homes.
Work with partners to improve interface between data bases to enhance  identification of people living in the community with Chronic Mechanical Ventilation

Barriers and strategies to address barriers, and resources required by Long Term Care Homes to support residents with tracheotomies and chronic mechanical ventilation are identified
Working in partnership with the Ontario Ventilator Equipment Pool and Hamilton Health Sciences Centre (operator of Integrated Decision Support), steps needed to link Ventilator Equipment Pool and Integrated Decision Support data are identified. Identify opportunities and implications of using an Integrated Funding Model approach to funding on-going operations focused on adults living with Chronic Mechanical Ventilation. 

Reduce Alternate Level of Care rates

London Health Sciences Centre, CCAC, Long Term Care, Parkwood, Participation House, Ontario Ventilator Equipment Pool




Vision Care - Phase 2
Investigate options to consistently collect and record visual acuity data to improve interdisciplinary decision making needed ensure positive outcomes for cataract surgery

Development and trial of a data collection system for pre/post cataract visual acuity 

Reduce wait time to specialist from family health care

All hospital corporations providing cataract surgery, primary care providers




Surgical Waitlist Management
To support implementation of surgical waitlist management at committed hospital sites. Additional funds required to cover unforeseen implementation costs and to support St. Thomas Elgin General Hospital to provide leadership and  spread to other hospitals across the LHIIN

Reduce wait times for surgery                      
Implement wait time management system at St. Thomas Elgin General Hospital this year with roll out across LHIN over multiple years

Reduce LHIN cost variance (Health Based Allocation Model hospitals) for acute/day surgery and Emergency Room

St. Thomas Elgin General Hospital, with spread to more hospitals as project evolves




Evaluation of current Behavioural supports Ontario Resources and High Risk Populations  
Analysis current Behavioural Supports Ontario resources to better understand the impact of Behavioural Supports Ontario initiatives to date and identification of opportunities to support vulnerable populations

Creation of a funding framework to assist in targeting resources to services that will provide the greatest impact for this population

Reduce Alternate Level of Care rate

Parkwood, Behavioural Supports Ontario project team, Mobile team members, Regional psychogeriatric teams, Long Term Care home embedded resources, Enhanced Psychogeriatric Resource Consultant, Alzheimer Societies, Adult Day Programs overnight respite providers



Back Office Collaboration and Integration Project
LHIN-wide review of the current state within the South West LHIN related to the Back Office Collaboration and Integration Project. The Project will focus on enabling effective and efficient use of system resources

Complete review of current state, development of a critical path and framework based on review and engagement with health service providers 


all LHIN funded providers



Mental Health and Addictions Community Capacity Coordinator
support the implement the Community Capacity Report and Community Capacity Report Refresh recommendations

Implementation of priority areas of supportive housing, coordinated access, peer support and quality performance


Huron Perth Healthcare Alliance, Mental Health and Addictions Health Service Providers


Drive safety through evidence-based practice


Exercise & Falls Prevention Classes
Enhance current funding to ensure sustainability of model. Investment will cover indirect costs to support continuation of programs and to enhance existing programs with capacity

People continue to have access to classes    

Programs have the financial resources to support classes to be able to operate                                    

Reduce rate of Emergency Room visits resulting from falls

Chippewas of Nawash, VON Grey Bruce, VON Perth Huron, Knollcrest Lodge, Mitchell & Area Community Outreach, One Care, Ritz Lutheran, Spruce Lodge, St. Marys & Area Home Support Services, Southwest Ontario Aboriginal Health Access Centre, VON Middlesex Elgin, VON Oxford



Antimicrobial Stewardship Program sustainability and spread       
Develop plan for antimicrobial stewardship across the South West LHIN

pilot critical care and spread to medical/surgical                                               

Reduce hospital acquired infection rates

London Health Sciences Centre, St. Thomas Elgin General as first community hospital




Aboriginal Asthma Community Education Tool Kit
Adaptation and production of resources from Asthma Society of Canada's toolkit, "Walking a Good Walk with Asthma" for Aboriginal communities

Culturally appropriate resources available for Aboriginal communities


Southwest Ontario Aboriginal Health Access Centre and Aboriginal Health Committee


Improve access to family health care


Aboriginal Traditional Healing Enhancement         
Enhance Traditional Healing Services within Southwest Ontario Aboriginal Health Access Centre's Integrated Care Model by adding a Traditional Healer Helper (Shkaabewis) in London, as best practice to increase equitable access to primary care and increase Aboriginal health status

Increased capacity to provide year round access to Traditional healing services and link between traditional healing and other primary care services                   

Reduce Emergency Room revisit rates within 7 days
Reduce hospital readmission rates within 30 days for selected Case Mix Groups

Southwest Ontario Aboriginal Health Access Centre




Partnering for Quality
Increase capacity of the Partnering for Quality team to further increase physician Electronic Medical Record optimization in the South West

Resource hired
Increased number of primary health care teams able to maximize the use of their Electronic Medical Record

Reduce rate of Emergency Room visits best managed elsewhere

CCAC, primary care providers



SOURCE South West Local Health Integration Network

For further information: Ashley Jackson, Director, Communications and Community Engagement, 519-672-0445 ext. 2604, 1-866-294-5446,

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