Mississauga Halton LHIN Board Meeting – January 29, 2009 · HPAC Update – a verbal update was...

Mississauga Halton LHIN Board Meeting – January 29, 2009

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Minutes of the January Meeting of the Board of Directors

MEETING DATE

January 29, 2009

LOCATION:

Mississauga Halton LHIN Office 700 Dorval Drive, Suite 500 Oakville ON

ATTENDANCE BOARD: John Magill (JNM) Brij Chadda (BC) Caesar Cheng (CC) Tim Costigan (TC). Ted Morris (TM). Jane McCarthy (JM) Norm Murray (NM)

STAFF: Bill MacLeod, CEO (WBM) Narendra Shah (NS) Sue Turcotte (ST) Diane Koz (DK) Bill Campbell (BC) Liane Fernandes (LF) Kitty Varley, Recorder (KV)

ABSENT WITH REGRETS: Elliot Halparin (EH) Enola Stoyle (EDS).

MINUTES APPROVED BY THE BOARD:

February 26, 2009

Guests:

1.0 Call to Order

Pursuant to public notice and a quorum being present, the meeting was called to order at 5:02 pm with JNM in the Chair. WBM advised members of the public of the protocol for attending MH LHIN Board meetings and clarified the MH LHIN process for assessing Board approval levels

2.0 Approval of the Consent Agenda and Conflict of Interest 5:04 pm The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming The Chair called for any items from the Consent Agenda that members would like brought forward for a more fulsome discussion. None were forthcoming MOTION:

It was moved by TM and seconded by BC that the Consent Agenda be approved as submitted. CARRIED [Resolution: 090129-01]


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3.0 Chair’s Report 5:08 pm

JNM called members attention to his report as circulated with the Consent Agenda. No questions or concerns were brought forward. A copy of a memo from Ron Sapsford, MOHLTC Deputy Minister, regarding cost constraints was circulated for the Board’s review. A copy will be filed with these minutes. JNM noted that the Ministry LHIN Accountability Agreement (MLAA) is required to be refreshed annually and added that NS and he are both members of that MLAA refresh committee. JNM advised that it is anticipated that the ‘refreshed’ MLAA will be ready for Board approval in June 2009 and added that this is the final year of the MLAA 3 year agreement. Negotiations are expected to begin midway through 2009 regarding the new MLAA. JNM added that the committee will have communiqués out within 72 hours of each meeting so the LHIN Boards can be kept apprised throughout the process. Video conferences will also be put in place. JNM provided an update on the Effectiveness Review committee and the committee’s recommendations. It is expected that the final timelines and implementation process will be available some time in February. JNM will keep the Board apprised as much as possible. The need for a special meeting of the Board in March to confirm the Board’s mandate with regard to our IHSP refresh was highlighted and will be discussed further during the IHSP discussion later in the meeting. Board Meeting Scheduling: A Briefing Note (BN) was provided in the meeting package noting the options for adjusting either the Audit and Finance Committee Meetings or the Board Meetings in order to permit a longer period of time between these two meetings. A discussion followed

Staff recommended to the Board that the option of moving the Audit and Finance Committee meeting be selected.

February 17th was discussed as the first revis ed date for the Audit and Finance Committee meeting. The Committee Chair is to be contacted to reconfirm when the change of dates to the Audit and Finance committee meetings would begin.

A motion was put forward on the understanding that the Committee Chair, who was absent, had previously indicated that either option presented would be acceptable to her.

MOTION It was moved by TC and seconded by CC, that the Audit and Finance Committee meetings be moved from the third Thursday of each month to the Tuesday of the week preceding the Board meeting week. Commencement of this revised scheduling to be confirmed by that committee Chair and the MH LHIN Finance Department. CARRIED [Res o lu tion : 090129-02]

4.0 MH LHIN Operations 5:18 pm

WBM drew the member’s attention to the January Management Report to the Board and invited questions and discussion. WBM elaborated on the Aging at Home strategy and advised that the MH LHIN’s presentation to the ministry was very successful.


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WBM advised that the actual cash flow will not likely begin until May or June. This may result in a Fall implementation. A brief discussion followed. TM drew members’ attention to the GTA Aboriginal Planning session in March and volunteered to represent our LHIN at that event.

• HPAC Update – a verbal update was provided by WBM. Dr. Geoff Morris has completed his year as Chair of the committee and Cathy Dibert, Director of Nursing at Trillium Health Centre will take on the role of Chair of HPAC.

This is a committee that reports to the CEO and as such WBM will be reporting regularly to the Board.

• Collaborative Structures: Materials related to the LHINC (formerly Collaborative Structures), was provided for the Board’s information. Questions were invited and a brief discussion followed.

WBM noted that the Collaborative Structures was previously approved in principle by the Board. It was now up to the LHIN CEOs to implement.

CEOs Certificate of Compliance

MOTION: It was moved by CC and seconded by NM that the CEO’s Certificate of Compliance dated January 23, 2009 be approved as submitted. CARRIED [Resolution: 090129-03]

5.0 Audit & Finance Committee 5:40 pm Reports from the December and January Audit and Finance Committee meetings were provided in the Consent Agenda for the Board’s information. Questions were invited. In the absence of the Committee Chair, TC brought forward the financial statement dated December 31, 2008 for the Board’s information and provided clarification as needed 6.0 Governance Committee 5:45 pm NM drew member’s attention to the Reports of the committee’s December and January meetings as included in the Consent Agenda.

Board / Staff Retreat – 2009. NM updated the Board on the Governance Committee’s discussion around the timing of the 2009 Board/Staff Retreat and added that the committee is recommending returning to the 2007 format of two nights and two days, ie the November Board meeting to be held at the Waterside Inn, with a Board gathering to follow that evening. The Retreat will then continue for two full days, November 30 and December 1st. It was felt that this extra evening would give more time for a roundtable type of discussion. It was further noted that Strategic Direction will be one of the main topics for the Retreat and that the scheduled roundtable session (apart from the Thursday evening), would not be placed at the end of the 2-day session. WBM added that this year we would be reviewing our 2 year Goals and Objectives. The IHSP Refresh will assist us in identifying these Goals and Objectives.


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It was added that a survey will shortly be forwarded to Board members regarding potential topics for the Retreat with an opportunity for priority ranking of those topics.

ACTION: Norm Murray with

MH LHIN Staff

Confirmation was provided that there are no ethnic or cultural holidays which will pose a conflict for either the Board or Senior Staff.

.

Review of Governance Policies (GP) 001-005: NM advised that the policies as sent out to members electronically would be further considered at the February Governance Committee meeting, and encouraged members to provide any further comments regarding possible revisions. The Committee plans to bring forward the revised GPs for approval by the Board at the February meeting, along with the proposed Board member compliance letter.

7.0 Community Nominations Committee 5:50 pm JM drew member’s attention to the Report of the committee’s December meeting as included in the Consent Agenda and provided a verbal update from the January 26th Committee meeting. NM advised the Committee Chair that he could be available to serve on the Board Member Selection Committee if needed. JM advised that 14 Letter noting interest in serving on the Board have been received. It is hoped that a slate of 10 candidates representing 2 per position for the first positions to expire, will be available to present to the PAS by August 2009. Facilitator training by tng has been scheduled for February 18th, 5:30 – 8:00 pm in the MH LHIN Office. BC recommended that a task of compiling a list of potential Board members and making such a list available to our provider, be added to our Work Plan. JNM noted that the Minister’s Office and the Chairs are recommending that a transition team be put in place, using external sources if needed, to assist the LHINs with the Board transitions. . 8.0 ER/ALC Update 6:02 pm NS reviewed the presentation regarding ER/ALC (Emergency Room / Appropriate Level of Care) as provided in the meeting package. Clarifications were provided as needed. WBM added that this is a direct investment map, but added that case management is handled by CCAC. NS noted that some areas are not being served. MH LHIN needs to be more active in these areas. 9.0 IHSP Refresh 6:40 pm Bill Campbell reviewed the Briefing Note (BN) and presentation provided in the meeting package and invited questions and discussion. In response to an inquiry from members, Bill Campbell confirmed that areas highlighted by various community engagements would be covered with a reference indicating what we have been able to accomplish and what we still need to work towards.


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JM encouraged advice to the public on what we have accomplished.

• Funding integration

10.0 MH LHIN Guidelines / Framework for Integration 7:05 pm WBM drew the Board’s attention to the MH LHIN Guidelines/Framework for Integration as provided in the meeting package and confirmed that this was for information at this point. This will be a focused topic at the February Board meeting. The Board will be asked to agree on the decision concepts contained therein. Staff will be bringing forward further materials to assist the Board in this review and decision in the period, prior to the February meeting. ACTION: Narendra Shah WBM reminded members that there are 4 types on integration.

• Voluntary integration • Facilitated integration • Required integration

11.0 MH LHIN Draft Communications Plan 7:15 pm WBM introduced the draft Communications Plan, as included in the meeting package, to members and noted that is was being presented for information today. A more fulsome discussion with input from the Board will be scheduled to help us move forward with this plan. The Board was requested to pass any thoughts on this process directly to CEO Bill MacLeod or Manager, Communications & Community Engagement, Diane Koz. After feedback is received, the plan will be presented more formally to the Board. ACTION: Bill MacLeod 12.0 Closed Session 7:40 pm MOTION:

Pursuant to s.9(5) of the Local Health Integration Act, 2006, it was moved by NM and seconded by BC that the January 29th Mississauga Halton Board Meeting move into Closed Session.

CARRIED [Resolution: 090129-04] On motion the meeting was returned to Open Session. 13.0 Meeting Adjournment 8:05 pm

MOTION: It was moved by CC and seconded by NM that the January 29, 2009 meeting of the Board of Directors be adjourned at 8:05 pm , with the next regularly scheduled meeting to be held on February 26, 2009 at 5:00 pm at the MH LHIN Office in Oakville.

. ___________________________ ______________________________ John Magill (Chair) Enola Stoyle, (Corporate Secretary)


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Action Item Summary – January 29, 2009 Board Meeting – Open Session

Action to be Taken Minutes’ Reference Responsibility A Survey regarding Board Retreat Topics and their Priority to be sent out

6.0 Norm Murray working with MH LHIN Staff

Further materials regarding Integration Guidelines to be forwarded to the Board

10.0 MH LHIN Staff

A more detailed Communications Plan with input from Board Members to be provided for Board approval

11.0 Bill MacLeod

Mississauga Halton LHIN Board Meeting – February 26, 2009

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Minutes of the February Meeting of the Board of Directors

MEETING DATE

February 26, 2009

LOCATION:


ATTENDANCE BOARD: John Magill (JNM) Brij Chadda (BC) Caesar Cheng (CC) Tim Costigan (TC). Elliot Halparin (EH) Ted Morris (TM). Jane McCarthy (JM) Norm Murray (NM) Enola Stoyle (EDS)

STAFF: Bill MacLeod, CEO (WBM) Narendra Shah (NS) Sue Turcotte (ST) Diane Koz (DK) Bill Campbell (BC) Monita O’Connor, (MO) Andrew Hussain Kitty Varley, Recorder (KV)

ABSENT WITH REGRETS:


March 26, 2009

Guests:

1.0 Call to Order

Pursuant to public notice and a quorum being present, the meeting was called to order at 5:14 pm with JNM in the Chair.

2.0 Approval of the Consent Agenda and Conflict of Interest The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming The Chair called for any items from the Consent Agenda that members would like brought forward for a more fulsome discussion. None were forthcoming MOTION:

It was moved by TM and seconded by NM that the Consent Agenda be approved as submitted. CARRIED [Resolution: 090226-01]


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3.0 Chair’s Report 5:16 pm

JNM called members attention to his report as circulated. No questions or concerns were brought forward. JNM drew member’s attention to the materials contained therein regarding updates from the Effectiveness Review. In response to a comment on the intensity of the process, JNM noted that in the majority of cases, the committee’s tasked to take on the recommendations of the Effectiveness Review are existing committees. The only new ones are those related to governance. JNM and fellow LHIN Board Chair, Kathy Durst will continue to provided update Briefing Notes as this process moves forward. JNM provided a further verbal update and indicated he is optimistic about the work of the Effectiveness Review implementation committee and the outcome.

4.0 MH LHIN Operations 5:25 pm

WBM drew the member’s attention to the February Management Report to the Board included in the Consent Agenda and invited questions and discussion. WBM provided a further update on the ER/ALC issues from those reported in the Management Report. In response to an inquiry, WBM advised that a discussion on the possible local purchase of a license for LTC beds would be held in Closed Session. Sr. Management thanked EH for assisting with a review of the OMA agreement. Staff noted some minor formatting changes that members felt would assist with clarity in future reports, including the date the report was prepared. Management further advised that the Board will be updated on the date and location of the self management task groups noted in the report. WBM added that some of these task groups are ‘trialing’. Each group is not a complete investment, but each will have an evaluation to determine which were more successful than others.


MOTION: It was moved by BC and seconded by EDS that the CEO’s Certificate of Compliance dated February 20, 2009 be approved as submitted. CARRIED [Resolution: 090226-02]

e-Health Update (5:43 pm)

Andrew Hussain (AH), MH LHIN’s CIO and e-Health Lead, provided an update on e-Health. A copy of the presentation was provided to members and is attached to the file copy of these minutes.

The handout provided invited LHIN e-Health Leads to respond to the document. Sarah Kramer, e-Health CEO will consolidate the responses. AH will advise the Board when the response consolidation is complete.


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AH noted that our LHIN’s e-Health strategy completely aligns with the ministry’s strategy.

AH provided a demonstration of the e-Health portal and added that it is hoped to have this portal ‘live’ by year end. In response to a query, AH confirmed that Ontario MD is being consulted.

A query was raised as to whether the cost would be to the individual physicians. AH could not confirm, but would find out and advise.

ACTION: Andrew Hussain

Communications Strategy 6:18 pm

Diane Koz (DK) provided a verbal update based upon the strategy included in the meeting package. DK elaborated and advised of future communications planning, particularly in community engagement.

ACTION: Diane Koz

A calendar of key dates will be provided at the end of next week. A Citizens’ Reference Panel is planned for the end of May. DK is hoping Board members will be able to make time to take part.

DK confirmed that targeted and specific communications will be prepared and we will be encouraging the use of our website for information.

Members noted that the definition of “diversity” as applied to community engagement should be broad, not just focused on cultural and ethnic diversity.

In response to a query, DK confirmed that the media will be included in our regular communications process, but will not be targeted.

Key dates in the communications process will be provided to the Board.

ACTION: Diane Koz 5.0 Audit & Finance Committee 5:40 pm

A verbal report from the February 19th committee meeting was provided by the Committee Chair. Questions were invited and responded to.

EDS drew member’s attention to the Financial Report for the period ending January 31, 2009, included in the meeting package for information and invited questions. EDS noted the Budgets for both Operations and e-Health were included in the Meeting Package for the Board’s approval. After discussion, motions were brought forward.

MOTION:

Its was moved by EDS and seconded by TC that the MH LHIN Budget for Operations as included in the meeting package be approved by the Board.

CARRIED [Resolution: 090226-03] MOTION:

It was moved by EDS and seconded by NM that the MH LHIN Budget for e-Health as included in the meeting package be approved by the Board. CARRIED [Resolution; 090226-04]


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A question regarding the major e-Health conference noted in the budget will be deferred to Closed Session.

Funding Acceptance MOTION:

It was moved by EDS and seconded by TC that the Board approve funding from the Ministry of Health and Long-Term Care (MOHLTC) of the $50K one-time funding in 08/09 and $200K base in 2009/10 and dispersal of the funds as indicated in Appendix A of the MOHLTC letter included in the Board meeting package.

CARRIED [Resolution: 090226-05]

Board Meeting Scheduling:

Sue Turcotte (ST) reviewed the BNs prepared and presented at the January Board meeting regarding Board and Committee meeting scheduling for Board members not present at that meeting.

After discussion, a motion was brought forward. MOTION;

It was moved by EDS and seconded by JM that the Audit and Finance Committee meetings would revert to their original schedule of being held the 3rd Thursday of each month. This motion contained the caveat that staff would put forth ‘best efforts’ to provide all material, including updates from the Audit and Finance Committee, in the Board package on the Friday prior to the Board meetings. Further materials and updates not available would be sent out on the Monday or Tuesday of the week of the Board meeting.

CARRIED [Resolution; 090226-06] 6.0 Governance Committee 7:09 pm

NM drew member’s attention to the Report of the committee’s February meeting as included in the Consent Agenda and invited questions from the members.

7.0 Community Nominations Committee 7:10 pm

JM drew member’s attention to the Report of the Committee’s February meeting as included in the Consent Agenda and advised that the committee and Board member selection panel were now in receipt of 15 applicants.

JM advised that the committee is in the process of assembling an information package for prospective Board members and invited members to advise her or any panel member of any information they feel should be included.

.


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. 8.0 ER/ALC Update 7:18 pm

WBM advised that at a recent Chairs/CEO joint meeting discussion on ALC/ER it was agreed that LHIN Boards needed to have this topic added to their agendas as a standing item to help each LHIN focus on performance related discussion. Our ALC coordinator, Dale Clement, will be attending the March meeting and will provide a presentation on ER/ALC at that time. WBM provided an update on the 1A status currently in place at our 3 hospitals. WBM explained that 1A designation is a means for changing the status of a patient awaiting transfer to a LTC Home whether from the community or from a hospital. Putting a full hospital into 1A status is a further iteration of this process and an attempt to alleviate the ER crisis being faced by our hospitals. It is a ‘crisis tool’ and will be removed once out of the crisis situation. It is anticipated the 1A designation will be removed at the end of the month, with some individual patients retaining a 1A designation.

9.0 MH LHIN Guidelines / Framework for Integration 7:35 pm

Monita O’Connor (MO) provided a presentation to the Board and invited questions and discussion. Copies of the presentation were handed out to members and a copy will be filed with the meeting minutes. A discussion followed regarding the options presented regarding the approval process.

Members noted that the financial impact may not be significant in some instances, but the impact on the community may be. This community impact needs to be considered along with the financial impact.

The Guidelines / Framework for Integration will be brought back to the Board at the March meeting. The Board was asked to consider the presentation given in preparation for that discussion. Are the criteria we have robust enough?

10.0 Closed Session 8:19 pm MOTION:

Pursuant to s.9(5) of the Local Health Integration Act, 2006, it was moved by CC and seconded by NM that the February 26th Mississauga Halton Board Meeting move into Closed Session.

CARRIED [Resolution: 090226-07] On motion the meeting was returned to Open Session. 13.0 Meeting Adjournment 9:00 pm

MOTION: On motion, the February 26, 2009 meeting of the Board of Directors be adjourned at 9:05 pm , with the next regularly scheduled meeting to be held on March 26, 2009 at 5:00 pm at the MH LHIN Office in Oakville.



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Action Item Summary – February 26, 2009 Board Meeting – Open Session

Action to be Taken Minutes’ Reference Responsibility

Mississauga Halton LHIN Board Meeting – March 26, 2009

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MEETING DATE

March 26, 2009

LOCATION:


ATTENDANCE BOARD: John Magill (JNM) Brij Chadda (BC) Caesar Cheng (CC) Tim Costigan (TC). Elliot Halparin (EH) Ted Morris (TM). Jane McCarthy (JM) Norm Murray (NM) Enola Stoyle (EDS)

STAFF: Bill MacLeod, CEO (WBM) Narendra Shah (NS) Bill Campbell (BC) Monita O’Connor (MO) Dale Clement (DC) Kitty Varley, Recorder (KV)



April 30, 2009

Guests:

1.0 Call to Order


2a. Approval of the Consent Agenda and Conflict of Interest 5:06 PM The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. The Chair called for any items from the Consent Agenda that members would like brought forward for a more fulsome discussion. In response to a member’s request, the Aging at Home Surveys and the ER/ALC Provincial View, provided as part of the Management Report to the Board, will be discussed in greater detail during the verbal portion of the Management Report. MOTION:

It was moved by EDS and seconded by TM that the Consent Agenda be approved as submitted. CARRIED [Resolution: 090326-01]


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2b. Approval of the Minutes from the February 26th

Board Meeting 5:15 PM MOTION:

It was moved by EDS and seconded by CC that the Minutes of the February 26, 2009 Board Meeting, Open Session, be approved as circulated.


3.0 Chair’s Report 5:16 PM

JNM called members attention to his report as circulated with the Consent Agenda. No questions or concerns were brought forward. JNM noted as of April, the Community Care Access Centres (CCACs) are no longer subject to the PAS appointment process. It was added that there is some concern at the Chairs’ level that some agencies and even some LHINs seem to be exhibiting an inability to recognize and apply the principles of good governance. The LHINC (LHIN Collaborative) is recognizing the desire and need for a change of focus on the part of the LHINs, from local work to collective issues in order to have a greater impact on common issues. The MH LHIN CEO, the ministry and the LHINC will be hosting a LHIN Consistency Workshop on March 31, to which the LHIN Board Chairs, CEOs, Ministry and provincial Thought Leaders have been invited. NM provided members with an update on his recent meeting with MPP Kevin Flynn and stressed the need for continued efforts to strengthen our MPP and Provider relationships It was suggested that it would be valuable to have an Education Session following the HNHB LHINs experience regarding the Ombudsman Investigation currently underway. A brief discussion followed

We will invite the HNHB LHIN to give us an update when the process concludes. ACTION: Bill MacLeod

4.0 MH LHIN Operations 5:25 PM

WBM drew members attention to the Management Report included in the Consent Agenda and provided a further verbal update. WBM advised that the LHIN CEOs and Chairs recently held a Joint Session on ER Wait Times. This is a very high priority for both the ministry and the LHINs and as such will be a Standing Agenda item at all future Board meetings. Dale Clement, MH LHIN ALC Lead was introduced and provided a presentation on ALC Strategy. A handout was provided at the meeting and an electronic copy will be forwarded to members. ACTION: Kitty Varley Ms. Clement reviewed her presentation with the Board and provided clarification as needed. WBM noted that despite lowering ALC numbers, the ER situation had worsened. WBM emphasized caution in our perception that ALC was the only factor impacting the ER Wait Times


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WBM clarified the CCAC Priority Classification process for admission to an LTC home and added that there is a re-education process which is attempting to move the first focus for placement from LTC homes to the best option for the patient, i.e. respite, support at home, transitional services etc. A discussion followed, which included the need for assistance for those needing a family physician and often one who would make house calls as many patients may not be able to travel or have access to a caregiver who could provide transportation to appointments. The discussion concluded at 5:59 pm. As noted in 2a above, the Aging at Home survey and the Provincial View, both included in the Management Report to the Board, were discussed. In response to a query, WBM will investigate the reference to improved utilization and # of day’s percentile, clarify the reasoning for waiting at home and provide such clarification at a future meeting. ACTION: Bill MacLeod/Narendra Shah A further discussion continued regarding the Provincial View and clarifications were provided as needed. With reference to presentations provided at previous meetings, WBM advised that we are moving towards formalizing our Integration and Decision Making Criteria. We have shared our Integration Guidelines with our legal counsel. These efforts have delayed the Board approval process somewhat, but we expect to have this back before the Board at the April meeting for approval.

ACTION: Bill MacLeod/Narendra Shah

An examination of how we can incorporate the HBAM methodology into our measure of integration outcomes and efficiencies was discussed. JNM added that this is also being discussed at Chairs/CEOs meetings.

The Board was advised that while the search for an Executive Director for the LHIN Collaborative (LHINC) continues, the Deputy Minister has selected a strategic council to deal with collaborative issues.

It was confirmed that the LHINC has no authority for decision making. Decisions must go through a common LHIN decision making process.

Some concern was expressed by members regarding the demands this process may make on staff at the expense of integration efforts.

A brief discussion on PRISM followed. It was noted that PRISM not only measures capacity, but is also looking at best practices which will improve efficiencies. It is a tool to assist the LHINs in providing reasonable and thoughtful advice to the ministry regarding a resolution to capacity issues.

The management report discussion concluded at 6:37 pm


MOTION: It was moved by EDS and seconded by CC that the CEO’s Certificate of Compliance dated March 20, 2009 be approved as submitted. CARRIED [Resolution: 090326-03]


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5.0 Audit & Finance Committee 6:45 PM EDS drew members’ attention to the Report of the February 19th Committee meeting included in the Consent Agenda and inquired if there were any questions or concerns regarding that report or the Financial Statement for the period ending February 28, 2009, or the Revenue Acceptance letter regarding the ER/ALC Lead. No questions or concerns were forthcoming. 6.0 Governance Committee 6:50 PM NM drew members’ attention to the Report of the committee’s March 13, Combined Governance and Community Nominations Committee meeting as included in the Consent Agenda and invited questions from the members.

A discussion followed regarding the review of the Governance Policies (GP) 001 through 005 as included in the meeting package.

NM noted that GP001, page 2 of 2, regarding Amendments will be revised to be consistent with the other GPs. A question was raised regarding the notation regarding ‘obtaining advice from counsel”. NM confirmed that the Committee Charters indicate that the committee chair(s) may obtain such advice directly. NM will confirm that the Charter supersedes the Governance Policies and Procedures. If that is not the case, the GP will be amended accordingly. ACTION: Norm Murray A discussion followed regarding the Board member compliance letter(s). It was agreed that EDS will note a minor amendment as discussed and forward to JNM for revision. An inquiry was put forward regarding the LHIN Boundary requirement for Board members. JNM advised that this is still a question being reviewed.

MOTION: It was moved by NM and seconded by CC that GP001, GP002, GP003, GP004 & GP005 be approved as included in the meeting package and as amended above.

CARRIED [Resolution: 090326-04] MOTION:

It was moved by TM and seconded by EDS that the Board member compliance letters be approved as included in the meeting package and as amended above.

CARRIED [Resolution: 090326-05] 7.0 Community Nominations Committee 6:55 PM JM drew member’s attention to the Combined Report as noted in the Governance Committee Chair’s report included in the Consent Agenda JM advised that 18 potential Board candidates have been met. The Panel Selection Committee plans to meet on March 30th to review their findings. More candidates are still being sought. JM also advised that all candidates have expressed an interest in serving on our provider Boards should they not be selected for the LHIN Board. We now need to develop a process to enable candidates to move towards our provider agency Board selection process.


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8.0 Closed Session 7:05 PM MOTION:

Pursuant to s.9(5) of the Local Health Integration Act, 2006, it was moved by TM and seconded by EDS that the March 26th Mississauga Halton Board Meeting move into Closed Session.

CARRIED [Resolution: 090326-06] On motion the meeting was returned to Open Session. 9.0 Meeting Adjournment 9:00 PM

MOTION: BC moved and TC seconded that the March 26, 2009 meeting of the Board of Directors be adjourned at 9:00 pm, with the next regularly scheduled meeting to be held on April 30, 2009 at 5:00 pm at the MH LHIN Office in Oakville.



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Action Item Summary – March 26, 2009 Board Meeting – Open Session

Action to be Taken Minutes’ Reference Responsibility Monitoring of HMHB Ombudsman investigation and invite HNHB LHIN to provide an update at a future meeting

3.0 Chair’s Report WBM

Providing a copy of the ALC Presentation to members TC and NM who participated by telecom.

4.0 Management Report KV

Confirm precedence of GPs vs Charters 6.0 Governance Report NM Guidelines for Integration – Final for Board approval 4.0 Management Report WBM` Possible action – WBM to confirm/clarify – clarification of the item – re improved utilization and # of days percentile – reasoning for ‘wait at home

Mississauga Halton LHIN Board Meeting – April 30, 2009

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MEETING DATE

April 30, 2009

LOCATION:


ATTENDANCE BOARD: Norm Murray (NM) – Acting Chair Brij Chadda (BC) Caesar Cheng (CC) Tim Costigan (TC). Elliot Halparin (EH) Ted Morris (TM). Jane McCarthy (JM) Enola Stoyle (EDS)

STAFF: Bill MacLeod, CEO (WBM) Narendra Shah (NS) Monita O’Connor (MO) Kim Delahunt (KD) Kitty Varley, Recorder (KV)

ABSENT WITH REGRETS: John Magill (JNM)


May 28, 2009

Guests:

1.0 Call to Order

Pursuant to public notice and a quorum being present, the meeting was called to order at 5:10 pm with NM in the Chair.

2a. Approval of the Consent Agenda and Conflict of Interest 5:10 PM The Acting Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. One addition to the Agenda was noted by the Acting Chair. A resolution from the CEO Evaluation and Compensation Committee will be brought forward. JM added a request that a discussion on Health and Safety be added during the Community Nominations Report. MOTION:

It was moved by TM and seconded by CC that the Agenda be approved as amended CARRIED [Resolution: 090430-01]

EDS requested that GP001 and the Compliance Letters included with the Consent Agenda be brought forward for a more fulsome discussion.


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A discussion followed regarding wait times as noted in the management report to the Board included in the Consent Agenda.

WBM noted that the MH LHIN is currently performing better than the provincial targets. Some areas that will remain negative are those in diagnostic imaging, particularly wait times for MRI.

WBM added that the MH LHIN has asked the medical directors and the administrative directors of our three hospitals to begin a discussion regarding the provincial guidelines for ordering MRIs. It is hoped a review of the ordering guidelines may result in a reduction to the demand for these diagnostic procedures.

In response to a query from CC regarding the wait times performance chart and the perception that trends appear to be worsening rather than improving, WBM advised that the government is reallocating funding away from some of the areas noted in red and yellow on the performance chart. In addition, some of the items noted in ‘red’ have been aggregated upwards and are now including new categories the LHIN was not previously trending. The LHIN plans to have a conversation around this issue with the ministry

A more fulsome discussion on this topic will be held at the May meeting. ACTION; Narendra Shah

As previously noted, a discussion regarding GP001 and the Board member compliance letters provided for information with the Consent Agenda, followed. EDS indicated the letters, as amended, did not represent her understanding of the revisions the Board had requested at the March meeting. EDS added that the she was concerned that the letters were too general and recommended specific policies be added to the letters along with a note referencing, “plus further policies that may be brought forward and approved from time to time”. EDS further recommended that the reference to OIC Guidelines be removed. It was also noted that none of our policies and procedures are signed off. After further discussion, the Acting Chair advised these comments will be taken back to the Governance Committee for further discussion at the June meeting. (the May meeting having been cancelled). This will be added to the Governance Committee’s report to the Board at the June Board meeting.

NM referenced the Governance Committee’s report from the April meeting provided in the Consent Agenda and encouraged members to provide feedback to that committee regarding planning for the Board Retreat at the end of November.

No further discussion was needed regarding the Consent Agenda.

MOTION: It was moved by EDS and seconded by CC that the consent agenda be approved as submitted.

CARRED [Resolution: 090430-02] 3.0 Chair’s Report 5:24 PM

NM called members attention to JNM’s report as circulated with the Consent Agenda. No questions or concerns were brought forward.


Page 3 of 7

4.0 MH LHIN Operations 5:25 PM

WBM drew members attention to the Management Report included in the Consent Agenda and provided a further verbal update.

WBM noted that progress has been made in ALC reductions. In an effort to gain more timely information, the LHIN has instituted a daily reporting process and extended our definition of ALC to include those patients in a variety of settings.

Members were also advised that the ministry has plans for emergency situations related to pandemic planning

DECISION MAKING GUIDELINES

WBM advised that the Decision Making Guidelines document, previously shared with the Board in draft form has been shared with our legal counsel and other LHIN CEOs

In an effort to move towards consistency within the LHINs, a working group will be created that will work with legal counsel and bring back a LHIN-wide consistent document

One of the key issues the working group will review will be the delegation of integration decisions. In the meantime, all integration decisions will be brought to the Board.

LHINC UPDATE WBM provided a verbal update on LHINC (LHIN Collaborative) and confirmed that a search is underway for an executive director for the LHINC. A communications document from the LHINC was provided in the meeting package for the Board’s information.

ANNUAL BUSINESS PLAN (ABP) WBM drew members attention to the Briefing Note (BN) provided in the meeting package. We are in the process of finalizing the ABP and expect to bring it to the Board during May and submit to the ministry at the end of that month.

INTEGRATED HEALTH SERVICE PLAN (IHSP) -

MH LHIN’s Manager of Communication and Community Engagement, Kim Delahunt (KD), drew members attention to the BN and related attachments included with the meeting package.

The calendar of events was reviewed and KD requested members advise her of any events in which they wished to participate.

Two major events were highlighted – The Citizen’s Panels, on May 30 and June 13th.

KD further advised that a survey will be posted on our website May 1st in both English and French soliciting public feedback.

Board member CC emphasized that we need to include some items from our previous IHSP that we have achieved and have these prepared for the citizens’ reference panel meetings. We need to note what we have accomplished, not just what we plan for the future.

It was noted by members that the reference to the seniors’ initiative has been renamed as ‘Senior’s Health’.

A discussion followed regarding this change. WBM cautioned the Board that including ‘Wellness and Quality of Life’, placed an expectation of accountability, which could result in a risk for the LHIN. After further discussion, a motion was put forward.


Page 4 of 7

MOTION:

It was moved by JM and seconded by BC that the LHIN retain the original wording regarding Seniors’ Health to reflect the initiative to be named ‘Seniors’ Health, Wellness and Quality of Life’



MOTION: It was moved by CC and seconded by EDS that the CEO’s Certificate of Compliance dated March 20, 2009 be approved as submitted. CARRIED [Resolution: 090420-04]

5.0 Audit & Finance Committee 6:25 PM EDS drew members’ attention to the report of the April Committee meeting included in the Consent Agenda and asked for any questions regarding the expense statement ending March 31st or the six month summary of Board Chair expenses included therein. None were forthcoming. Risk Management Framework The Risk Management Framework was reviewed and discussed. Numbering will be added to the next iteration. Trillium Health Centre Revenue Acceptance ST provided background on this funding and noted the letter is in draft at this point as the original was still awaiting signature. This funding is going directly to the hospital from the ministry.

MOTION: It was moved by EDS and seconded by TC that the revenue as outlined in the ministry letter to Trillium Health Centre as provided in the meeting package be accepted.

CARRIED [Resolution: 090430-05] 6.0 Governance Committee 6:50 PM NM drew members’ attention to the Report of the committee’s April Governance Committee meeting as included in the Consent Agenda. NM noted that the agenda items noted under Governance were covered in the Consent Agenda discussion

7.0 Community Nominations Committee 6:55 PM JM provided a verbal update on the committee’s activities. JM advised that the search for new Board members is progressing. We have possibly 30 candidates all of a very high calibre. Information sessions have been completed for all applicants thus far and 16 formal panel interviews have been completed. The committee is targeting to have completed the process on or about the first week of June. A process has yet to be determined on how to assist the Boards of our HSPs to solicit new members from the LHIN candidates who are not selected for our Board.


Page 5 of 7

JM further advised that a meeting with our provider Boards, to be facilitated by tng, is being planned for either June 23 or June 24 from 5:00 until approximately 8:00 pm. Further details will be provided as they are confirmed by the committee and KD. Further to the candidate selection process, BC questioned the stipulation that the Chair of the Audit and Finance Committee be a CA. EDS advised that she supported this requirement to ensure due diligence and to monitor internal risk controls. As noted in 1.0 above, JM raised the question of Safety in the Workplace and referenced a presentation provided to the Board and Staff last year. JM requested a report at the May Board meeting as to how we have acted on the recommendations brought forward through that presentation.

ACTION: Bill MacLeod and LHIN Staff

8.0 Integration Activities 6:45 PM Two integration initiatives were brought forward. BNs and supportive materials were provided in the meeting package. 8.1 For Information Direct Access to Primary Percutaneous Coronary Intervention (PPCI) for Trillium Health Centre (THC). WBM drew members attention to the BN included in the package and provided clarification as needed. 8.2 For Approval Development of Integrated Vascular and Thoracic Surgery Regional Programs WBM drew members’ attention to the BN and supportive material included in the meeting package. NS added this is a much needed regional program. It is expected this integration will be completed within 6-7 months. HHS would like to participate in the long term, but currently have a surgeon who handles both thoracic and vascular surgery. CC recommended that the BN could be improved by denoting that this is funding for an integration initiative and indicating the expectations resulting from the integration, ie reduced costs, improved wait times etc. ACTION: Narendra Shah MOTION:

It was moved by CC and seconded by BC that the Development of an Integrated Vascular and Thoracic Surgery regional program be established between Trillium Health Centre (THC) and Credit Valley Hospital (CVH)

CARRIED [Resolution: 090430-06] . 9.0 Resolution from the CEO Evaluation and Compensation Committee As noted in Item 1.0 a further item was added to the agenda for discussion. The acting Chair read the resolution, which was provided in the meeting package, for the Board’s information and invited discussion MOTION:

It was moved by EDS and seconded by TC that the CEO Evaluation and Compensation Committee resolution be approved as read with a copy to be filed with the Board minutes.



Page 6 of 7


Pursuant to s.9(5) of the Local Health Integration Act, 2006, it was moved by CC and seconded TM that the April 30thMississauga Halton Board Meeting move into Closed Session.


MOTION: It was moved by BC seconded CC that the April 30, 2009 meeting of the Board of Directors be adjourned at 9:00 pm, with the next regularly scheduled meeting to be held on May 28, 2009 at 5:00 pm at the MH LHIN Office in Oakville.

. ___________________________ ______________________________ Norm Murray (Acting Chair) Enola Stoyle, (Corporate Secretary)


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OPEN Action Item Summary – April 30, 2009 Board Meeting – Open Session

Action to be Taken Date and number Minutes’ Reference

Responsibility

Monitoring of HMHB Ombudsman investigation and invite HNHB LHIN to provide an update at a future meeting

March 26, 3.0 Chair’s Report

WBM

Wait Times Performance Chair – a more fulsome discussion April 30 – Management Report

NS

Integration Initiatives – add expectation resulting from the integration to the BN

April 30 – Integration Initiatives

NS

Follow up to the Safety Presentation made last year April 30 – 7.0 WBM & Staff

Mississauga Halton LHIN Board Meeting – May 28, 2009

Page 1 of 7

Minutes of the May Meeting of the Board of Directors

MEETING

DATE

May 28, 2009

LOCATION:


ATTENDANCE

BOARD: John Magill, (JNM) Chair Norm Murray (NM) Brij Chadda (BC) Tim Costigan (TC). Elliot Halparin (EH) Ted Morris (TM). Enola Stoyle (EDS)

STAFF: Bill MacLeod, CEO (WBM) Narendra Shah (NS) Monita O’Connor (MO) Kim Delahunt (KD) Bill Campbell (BC) Kitty Varley, Recorder (KV)

ABSENT WITH

REGRETS: Jane McCarthy (JM) Caesar Cheng (CC)


June 25, 2009

Guests:

1.0 Call to Order


2.0. Approval of the Consent Agenda and Conflict of Interest 5:11 PM The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. MOTION:

It was moved by EDS and seconded by TC that the Consent Agenda be approved as provided in the meeting package. CARRIED [Resolution: 090528-01]

Business Arising from the April 30th Board Meeting Minutes: WBM provided an update on WSIB reporting from our LHIN’s hospitals. A handout summarizing the

hospitals’ data along with a comparison to the data provided in May 2008 was provided. WBM elaborated on the data provided and invited discussion.

WBM noted that the CEO of Ontario’s Health and Safety Institute is working on obtaining permission for the LHIN to receive this data directly from the institute in future. It is not anticipated that this will be a problem.

A further update will be provided at the September meeting. This handout as well as any further meeting handouts will be added to the Board’s eBinder and posted on

the Board’s website.


Page 2 of 7


JNM called members attention to The Chair’s Report as circulated with the Consent Agenda. No questions or concerns were brought forward.

JNM corrected a point in the report which noted that the LHINs’ June 3rd/4th Accountability Consensus meeting had been deferred. JNM confirmed that this meeting remains scheduled for June 3rd and 4th and added that one of the goals of this meeting will be to begin the process of adjusting LHIN indicators from outcome indicators to input indicators. It is hoped this will lead to a different manner of operating for the LHINs and encourage them to think more collectively. An update on the Minister’s Roundtable Session at the MH LHIN on May 26th was provided for the Board’s information. JNM added that the roundtable format worked very well for all participants. The session was attended by a cross section of our provider base as well as MPPs from the MH LHIN. JNM noted that at the recently held MPPs Breakfast, it was suggested regular communication meetings with MPP administration and LHIN administration could help improve the communications process. ACTION: Kim Delahunt 4.0 MH LHIN Operations 5:25PM Management Report:

WBM drew members attention to the Management Report included in the Consent Agenda. NS briefly reviewed the report with members. In response to a query regarding the LHIN’s role in the expansion of Family Health Teams (FHTs), NS advised that a working group is currently in place. WBM added that it has been suggested by the ministry that the management of agreements be assigned to the LHINs. Responsibility for negotiating the agreements would remain with the ministry. This would need to be negotiated with the OMA. Further discussion followed with clarifications being provided by NS and WBM.

LHINC Update

WBM provided a verbal update on the LHIN Collaborative (LHINC), and added that he would be attending interviews for the LHINC ED position on May 29th.

Annual Business Plan (ABP)

A Briefing Note (BN) and Draft ABP were provided in the meeting package for the Board’s information and discussion. NS confirmed that all comments received to date have been incorporated into the current Draft. The Board was asked to provide any further comments directly to Bill Campbell at [email protected] by mid June as the final draft is required to be submitted to the ministry by the end of June. The final ABP will be provided to the Board at the June meeting. WBM added that the ABP will represent the plan for the LHIN’s activities for the next 12 months.


Page 3 of 7

BC noted that although ‘Wellness and Quality of Life’ had been reinstated within the title for the seniors’ initiative, the spirit or culture of that title appeared to be lacking in the plan itself. WBM added that prevention is noted under various other items in the plan. The ASSIST model identifies areas that will bring about a greater sense of wellness. EH suggested perhaps a note dedicated to prevention within each section or a separate section dedicated to prevention may speak to this concern. Staff will take the member’s comments into account in the next iteration of the plan ACTION: Bill Campbell WBM added that the priorities in the ABP need to relate back to, and be reconciled with, the CEOs objectives

IHSP Refresh

Concern was expressed regarding the perception that may be created by the decision to move Primary Care from a ‘priority’ to one of the IHSP’s ‘enablers’ and added that this may diminish the LHIN’s ability to gain support from physicians. Despite WBM’s assurance that ‘enablers’ and ‘priorities’ had equal importance, some felt that may not be the reader’s perception. Staff may consider moving the ‘enablers’ to a position earlier in the IHSP to improve the perception of import. Kim Delahunt (KD) drew members attention to the BN provided with the IHSP in the meeting package and added an update to the survey completion figures, noting 414 completed surveys had been received to date. The survey results will be brought to the Board at the June meeting

ACTION: Kim Delahunt

KD provided a brief update on the upcoming planned Citizen’s Reference Panels and advised that our vendor, MASS, will be providing a full report on all our community engagement events before the end of June. Staff will review the report and then share with the Board along with the results of our own related internal LHIN meetings.

After further discussion, it was determined that a Special Board meeting devoted to the IHSP Refresh may be needed.

As Chair of the Audit and Finance Committee, EDS offered to move that committee’s meeting to July 23rd in order to free up July 16th for a Special Board meeting to review the IHSP Refresh.

Members agreed a meeting devoted to this important topic was needed. Appropriate calendar confirmations will be forwarded confirming a Special Board Meeting for July 23rd and a rescheduling of the Audit and Finance Committee meeting as noted.

ACTION: Kitty Varley as meeting

Recorder


Page 4 of 7

Annual Report

NS reminded members that the Annual Report needs to be sent out for translation into French, so any further input from members must be received by the end of the first week in June.

Members praised the anecdotal style incorporated into the current Annual Report. CEOs Certificate of Compliance MOTION:

It was moved by EDS and seconded by TC that the CEOs Certificate of Compliance dated May 22nd, as included in the meeting package be approved as submitted.

CARRIED [Resolution: 090528-02] (Although noted in the Agenda as Item 9, it was agreed to bring the Wait Times presentation forward to this point in the meeting.) 5.0 Wait Times 6:44 PM Monita O’Connor (MO) provided a presentation on Wait Times, a copy of which will be added to the eBinder on the Board’s website. In response to a query on the targets noted in the presentation, WBM advised that these targets are set by clinical reference panels, not by administrators. A request was made for a follow up on level definitions and specific volumes or numbers of patients in the various levels. ACTION: Monita O’Connor After a brief discussion on the process of physician MRI ordering, WBM agreed to discuss further with EH. EH further offered to assist on the issue of cataract surgery wait times. Following further comments from members, staff offered to provided a summary on background information around Wait Times for the Board’s review either quarterly or on a six month review basis. Staff will note whether changes represent actual trends or a statistical change only. This process can be confirmed at the June meeting. ACTION: Monita O’Connor 5.0 Audit & Finance Committee 7:26 PM EDS drew members’ attention to the report of the May Committee meeting included in the Consent Agenda and asked for any questions regarding the approved expense statement ending March 31st or the draft expense statement ending April 30th. None were forthcoming. EDS further noted the Revenue Acceptance items, provided for the Board’s information and included in the Consent Agenda and invited questions or discussion.


Page 5 of 7

Post Audit Report from the MH LHIN Auditors, Deloitte and Touch and the Financial Statements resulting from the Audit Report for fiscal year 2008-2009

EDS expressed some disappointment that the consulting report recommendations for going forward were written very generically and advised that at the Audit and Finance Committee’s request, one page of the report was modified to focus specifically on the MHLHIN. After inviting further comments from MH LHIN Management, EDS put forward a motion for approval. MOTION:

EDS moved and TC seconded that the Financial Statements as audited by Deloitte & Touche as provided in the meeting package be approved.

CARRIED [Resolution: 090528-03] Appointment of Auditors for the Fiscal Year 2009-2010

EDS provided background information regarding the RFP process for the appointment of the LHIN’s auditors for 2009-2010 and drew members’ attention to the information note and related material included in the meeting package.

BC added input resulting from his experience serving on the auditor selection committee and added advice to the Board that the applicants and the selected vendor may have the expectation that the contract would be for a 3 year period.

MOTION:

It was moved by EDS and seconded by TC that Deloitte and Touch be approved as the Auditors for the MH LHIN Audit for fiscal year 2009-2010

CARRIED [Resolution: 090528-04] 6.0 Governance Committee 7:40 PM NM drew members’ attention to the member compliance letters as included for information in the Consent Agenda. The letters will be prepared for member’s signature at the June Board meeting. 7.0 Community Nominations Committee 7:43 PM In the absence of the Committee Chair, TM provided an update on the OIC appointment process. TM advised that all interviews will be completed by May 29th and a meeting of the selection panel to finalize their results and recommendations is scheduled for early June. JNM confirmed that the morning of two dates, June 8th and June 9th have been set aside for the panel to develop go forward plans for candidate recommendations and a communication plan for not only the candidates, but also for the Board. It was also noted that all candidates have been invited to the June 24th community engagement session.

8.0 Integration Activities 7:48 PM It was noted that Integration Activities is a Standing Agenda Item. Page 3 of 10 of the Management Report to the Board, included in the Consent Agenda, provides an update on Integration Activities. In future, this will be noted at the beginning of the Management Report. ACTION: Narendra Shah


Page 6 of 7


Pursuant to s.9(5) of the Local Health Integration Act, 2006, it was moved by BC and seconded by TM that the May 28th Mississauga Halton Board Meeting move into Closed Session.


MOTION: It was moved by TM and seconded EDS that the May 28, 2009 meeting of the Board of Directors be adjourned at 9:00 pm, with the next regularly scheduled meeting to be held on June 25, 2009 at 5:00 pm at the Living Arts Centre in Mississauga, following the presentation by Dr. Alan Hudson at that same location.

. Original Signed by: Original Signed by: ___________________________ ______________________________ John Magill, Chair Enola Stoyle, (Corporate Secretary)


Page 7 of 7

OPEN Action Item Summary – May 28, 2009 Board Meeting – Open Session


Responsibility



WBM

Mississauga Halton LHIN Board Meeting – June 25, 2009

Page 1 of 6

Minutes of the June Meeting of the Board of Directors

MEETING

DATE

June 25, 2009

LOCATION:


ATTENDANCE

BOARD: John Magill, (JNM) Chair Norm Murray (NM) Brij Chadda (BC) Tim Costigan (TC). Elliot Halparin (EH) Ted Morris (TM). Jane McCarthy (JM) Enola Stoyle (EDS)

STAFF: Bill MacLeod, CEO (WBM) Narendra Shah (NS) Monita O’Connor (MO) Kim Delahunt (KD) Bill Campbell (BC) Kitty Varley, Recorder (KV)

ABSENT WITH

REGRETS: Caesar Cheng (CC)


July 30, 2009

Guests:

1.0 Call to Order


2.0. Approval of the Consent Agenda and Conflict of Interest 5:03 PM The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. The Chair noted that a further item around a discussion on Diversity would be added and that the discussion around Board candidates would be held in Closed Session. Upon request from EDS, the Chair agreed that future agendas will reflect the approval wording of the Consent Agenda as, ‘Approving the Agenda and Accepting the Consent Agenda’

MOTION: It was moved by NM and seconded by EDS that the Agenda be approved as amended and the Consent Agenda be accepted as provided in the meeting package. CARRIED [Resolution: 090725-01]

Business Arising from the April 30th Board Meeting Minutes:

In response to a query from JM, WBM provided a brief update on WSIB and noted that this would also be on the Agenda for the September Board meeting


Page 2 of 6


JNM called members attention to The Chair’s Report as circulated with the Consent Agenda. Some discussion was held and clarification provided by WBM around the accreditation process as noted in the Chair’s report. It was further confirmed that all MSAAs have been signed. 4.0 MH LHIN Operations 5:25:PM Management Report:

WBM drew members attention to the Management Report included in the Consent Agenda and provided clarification as needed. In response to a query on MH LHIN e-Health activities, WBM noted that the majority of e-health activities are dependant on what E-Health Ontario rolls out. We are currently trying to determine the path on which we will be proceeding. The Board will be kept apprised. WBM provided further clarification regarding the Diabetes Registry and noted that the goal is to make this a valuable tool for clinicians.

LHINC Update WBM provided a verbal update on the LHIN Collaborative (LHINC) and advised that the membership on the newly formed LHINC Council will be announced shortly with the first Council meeting planned for late August. Following that meeting WBM’s commitment to that group will be somewhat diminished.

Annual Business Plan (ABP) 2009/2010 A Briefing Note (BN) and copy of the ABP were provided in the meeting package for the Board’s approval. Bill Campbell provided further update to the BN provided and clarified issues as needed. WBM noted in response to a query that the LHINs need to undertake to develop some measures that the province can roll up into a provincial perspective. What we are stating now in our ABP are ‘aspirational outcomes’.

JNM added that the MLER does comment on ‘measures’ and as a result the LHIN/Ministry working groups have expanded to include discussions on how output can be measured. This will be part of the new MLAA work that is ongoing.

MOTION:

It was moved by TC and seconded by TM that the MH LHIN Annual Business Plan be approved as provided in the meeting package

CARRIED [Resolution: 090725-02] MH LHIN Annual Report 2008/2009

A Briefing Note (BN) and copy of the Annual Report for 2008/2009 were provided in the meeting package for the Board’s approval. Bill Campbell provided further background information and provided clarifications as needed.

A final document with some minor editing changes will be provided to the Board. ACTION: Bill Campbell MOTION:

It was moved by EDS and seconded by TM that the MH LHIN Annual Report be approved as provided in the meeting package and reflecting the minor editing as discussed.



Page 3 of 6

Ministry LHIN Accountability Agreement A copy of the Amended Ministry LHIN Accountability Agreement was provided to the Board for review and provided in the meeting package for Board approval. MOTION

It was moved by TC and seconded by NM that the Board provide approval of the MLAA as noted below

Approval that the Accountability Agreement between the Ministry and the MH LHIN effective as of

April 1, 2007 be amended as set out in the draft amending agreement, a copy of which is included in the meeting package; and;

That the Chair be authorized to execute the final version of the amending agreement on behalf of the MH LHIN provided that the content of the execution copy of the amending agreement is substantially similar to that of the copy included in the meeting package


IHSP Refresh

A verbal update was provided by Kim Delahunt (KD). The Board was advised that a final Community Engagement Report will be forthcoming from MASS and will be forwarded to the Board with comments from management.


KD further confirmed that material for the Special Board meeting scheduled for August 6th will be provided one week prior to the meeting.

ACTION: Kim Delahunt CEOs Certificate of Compliance MOTION:

It was moved by NM and seconded by TM that the CEO’s Certificate of Compliance dated June 18, 2009 be approved as provided in the meeting package

CARRIED [Resolution:090725-05] 5.0 Audit & Finance Committee 6:17 PM EDS drew members’ attention to the report of the June Committee meeting as well as the other items noted in the Consent Agenda included in the meeting package and asked for any questions regarding the items contained therein. Revised GP006 – Signing Authority

EDS reviewed the revised GP006 contained in the meeting package and invited discussion and questions. MOTION:

EDS moved and TC seconded that the GP006, Signing Authority as provided in the meeting package be approved CARRIED [Resolution: 090725-06] ]


Page 4 of 6

Revenue Acceptance EDS provided an overview of the e-Health Ontario revenue acceptance letter as included in the meeting package and invited discussion

MOTION:

EDS moved and TC seconded that the e-Health Ontario revenue of $600,000 to manage e-Health deployment initiatives within the MH LHIN as per the June 11, 2009 letter from eHealth Ontario included in the meeting package be approved.

CARRIED [Resolution: 090725-07] 6.0 Governance Committee 6:19 PM NM drew members’ attention to the Committee’s June meeting report included in the Consent Agenda and invited questions. NM further noted that the Member Compliance letters were now available for signing. NM noted that as per the Work Plan, a discussion on Board Meeting Effectiveness will be held at the July committee meeting and asked members to provide him with any input on this topic prior to that committee meeting. EDS provided a copy of the MH CCAC AGM meeting evaluation and governance scorecard for the Committee Chair’s information and consideration during these discussions. Board Retreat

A draft agenda for the 2009 Board/Staff Retreat was provided in the meeting package and brought forward for discussion. NM asked that any input regarding the draft agenda be sent to either himself or to the Board Chair. A brief discussion followed as to holding a ‘farewell’ to the first group of departing Board members at the Retreat. Members were asked to consider this and provide feedback to NM or the Board Chair. EDS noted that at the June Audit and Finance Committee meeting a discussion was held around the budgeting of per diems. EDS requested that staff provide a BN on how this can be accomplished and advise the Governance Committee for their consideration around how the per diems can be used to gain the most benefit for the LHIN. ACTION: Sue Turcotte NM further noted that a discussion was held on the need for a signature on Governance Policies (GPs). It was recommended that anything in DRAFT will show a ‘Watermark’ and added that the amendment dates and times will be noted at the bottom of the documents. The approval date will be noted in the document heading. A signature is therefore not required. EDS further noted that the issue of reciprocal signing of expense reports will be reviewed at a future Audit and Finance Committee meeting and the Board will be advised of any resulting recommendations.

7.0 Community Nominations Committee 6:28 PM The Board renewal process has been documented. JNM plans to share the documented process with the other LHIN Board Chairs upon formal completion of the process documentation. As noted in 2.0 above the discussion around proposed Board candidates will be moved to Closed Session. 8.0 Integration Activities 6:35 PM Members’ attention was drawn to the Management Report to the Board, which contains a section on Integration Activities. This is a Standing Item and will also form an ongoing part of the Management Report.


Page 5 of 6

9.0 Diversity 6:38 PM As noted in 2.0 above, this topic was added to the agenda. Board member BC provided a handout and reviewed it with the group providing clarification as needed. A copy will be added to the eBinder on the Board’s website along with the approved minutes. The Chair asked members to consider the presentation provided. This topic will be brought back to the Board in the near future for further discussion and consideration. NM added that the presentation forwarded to the Board from Monita O’Connor on Wait Times might be considered as a potential separate Agenda Item for a future Board Meeting. The Chair will consider this recommendation. ACTION: John Magill 10.0 Closed Session 6:52 PM MOTION:

Pursuant to s.9(5) of the Local Health Integration Act, 2006, it was moved by NM and seconded by JM that the June 25th Mississauga Halton Board Meeting move into Closed Session.

CARRIED [Resolution: 090625-08] On motion the meeting was returned to Open Session. 11.0 Meeting Adjournment PM

MOTION: On motion the June 25, 2009 meeting of the Board of Directors be adjourned at ? pm, with the next regularly scheduled meeting to be held on July 30, 2009 at 5:00 pm at the Mississauga Halton LHIN Office in Oakville.

. Original Signed by: Original Signed by: ___________________________ ______________________________ John Magill, Chair Enola Stoyle, (Corporate Secretary)


Page 6 of 6

OPEN Action Item Summary – May 28, 2009 Board Meeting – Open Session


Responsibility



WBM

Mississauga Halton LHIN Board Meeting – July 30, 2009

Page 1 of 4

Minutes of the July Meeting of the Board of Directors

MEETING

DATE

July 30, 2009

LOCATION:


ATTENDANCE

BOARD: John Magill, (JNM) Chair Norm Murray (NM) Brij Chadda (BC) Tim Costigan (TC). Elliot Halparin (EH) Ted Morris (TM). Enola Stoyle (EDS) Caesar Cheng (CC)

STAFF: Narendra Shah (NS) Kim Delahunt (KD) Bill Campbell (BC) Sue Turcotte (ST) Kitty Varley, Recorder (KV)

ABSENT WITH

REGRETS: Jane McCarthy


August 27, 2009

Guests:

1.0 Call to Order


2.0. Approval of the Consent Agenda and Conflict of Interest 5:00 PM The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. JNM welcomed our guests from the public and advised of the protocol for observers at MH LHIN Board meetings.

MOTION: It was moved by NM and seconded by CC that the Consent Agenda be approved as provided in the meeting package. CARRIED [Resolution: 090730-01]

Business Arising from the June Board Meeting Minutes: JNM noted that during the June Board meeting there was some discussion on Diversity based on a document provided by Board member BC. JNM and BC have since discussed this topic and this work has been combined with work that is ongoing with the CEO and senior staff. It is anticipated that an update will be provided at the September Board meeting. KD acknowledged BC’s offer to assist if needed.


Page 2 of 4


JNM called members attention to The Chair’s Report as circulated with the Consent Agenda, elaborated on certain points and provided clarification as needed.

Members’ attention was drawn to a letter sent to the Chairs by ADM Ken Deane and forwarded to the Board for information. Although not part of the meeting package this letter referenced points included in the Chair’s report. The ADM’s letter referenced ‘cross LHIN work’ and the newly formed LHINC (LHIN Collaborative)

JNM noted that he has recently received a new Procurement Directive and related reporting requirements from the ministry. JNM added that there is no minimum associated with the newly provided directive and that the LHIN is required to send confirmation to the ministry, by August 14th, that we are in compliance with the new directive.

ACTION: Narendra Shah.

CEO Goals and Objectives: After a brief discussion a motion was put forward. MOTION:

It was moved by NM moved and seconded by TC that the CEO Goals and Objectives for 09/10 be approved as previously circulated and provided in the meeting package.

CARRIED [Resolution: 090730-02] 4.0 MH LHIN Operations 5;15:PM Management Report:

NS drew members’ attention to the Management Report included in the Consent Agenda and provided clarification as needed. NS noted that the Renal Network Regional Lead had been determined as noted on page 2 of the report and added that the Diabetes Strategy is moving forward. Halton Healthcare Services will be the lead on this initiative. It is further anticipated that priority high need population areas for diabetes education (with excellent ICES data) will be determined by the end of August. In response to a query from the Board, NS confirmed that transportation issues will be a consideration in determining sites for the Diabetes program expansion. NS provided clarification on the Homefirst strategy referenced on page 5 of the report and noted that an update on the new Respite Program will be provided at the September Board meeting. ACTION: Narendra Shah

LHINC Update

JNM noted that the LHINC (LHIN Collaborative) will be taking the lead on the new L-SAA, the new H-SAA. the HAPS process and Indicator Selection. JNM anticipates that further initiatives will be added to the LHINC mandate as it moves forward.

Further updates are expected in the Fall. ACTION: Bill MacLeod


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CEOs Certificate of Compliance MOTION:

It was moved by EDS and seconded by NM that the CEO’s Certificate of Compliance dated July 27th 2009 be approved as provided in the meeting package

CARRIED [Resolution: 090730-03] 5.0 Audit & Finance Committee 5:40 PM EDS drew members’ attention to the report of the July Committee meeting as well as the other items noted on the Consent Agenda, included in the meeting package, and asked for any questions regarding the items contained therein. EDS provided some background on the per diem reporting included in the Consent Agenda. In response to a query regarding a Board Work Plan, JNM confirmed that a Work Plan is in process. EDS also drew members’ attention to the list of Policies and Procedures. A copy of the provincial Whistle Blowing Policy was provided to her committee in response to a request from the A&F Committee. EDS put forward the concept of a TIP line for Whistle Blowing and added that her committee will consider this at its August meeting. 6.0 Governance Committee 5:48 PM NM drew members’ attention to the Committee’s meeting report from July, included in the Consent Agenda.

In response to a query, KD confirmed that a report from the recent Governance to Governance (G2G) session will be forthcoming.

ACTION: Kim Delahunt Staff/Board Retreat

NM noted that a Draft Staff Board Retreat Agenda was included in the meeting package and encouraged members to forward their comments directly to either himself or Kim Delahunt. In response to a request from EDS, the Governance Committee will consider moving the Spouse’s dinner to an alternative evening.

G2G Update.

KD provided an update on the invitation to attend the G2G session on September 30th at the Living Arts Centre. The topic will be the IHSP.

Board Member Effectiveness Survey. NM updated members on the survey and encouraged those members who have not completed the survey to do so at their earliest convenience.

Board Education Topics.

KD provided an update on the proposed topics and added that 20 surveys regarding topics had been received. These will be discussed at the next Governance Committee Meeting. The topic for the September Education Session will be the CSS and its impact on ER/ALC & Healthy Living as highlighted in the ministry’s strategic plan. ST advised that a webinar can be investigated as an option for members unable to attend in person.



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7.0 Community Nominations Committee 6:03 PM JNM provided an update in the absence of the committee chair. JNM confirmed that the MH LHIN recommendations for OIC appointments to the Board were submitted on July 14th to the Minister and to the PAS I(Public Appointments Secretariat) and added that he has subsequently met with a senior member of the Minister’s staff regarding the OIC appointment process. The committee now will be focused on the completion of our process and following up with our HSPs to identify any openings on their respective Boards for which some of our candidates might be a fit. The Orientation Process is also being reviewed ACTION: John Magill and Kim Delahunt JNM added that if the ministry and Cabinet move forward with our recommendations, the LHIN could be advised as early as September. JNM further noted that the wrap up of the MLER recommendations will be forthcoming. A part of those recommendations will be a review of the OIC process.

8.0 Integration Activities 6;15 PM NS drew members’ attention to the section in the Management Report on Integration Activities. In response to a query regarding a listing of all integration activities, including those not being pursued at this point, NS provided a verbal update highlighting the Vascular, Neurosurgery and CKD initiatives with Halton Healthcare and Trillium respectively as well as the Maternal Child program for which Credit Valley Hospital is taking the lead. The list referenced above will be added as part of the Standing Item on Integration Activities at the September meeting. ACTION: Narendra Shah 9.0 Closed Session 6:30 PM MOTION:

Pursuant to s.9(5) of the Local Health Integration Act, 2006, it was moved by EDS and seconded by NM that the July 30th Mississauga Halton Board Meeting move into Closed Session.

CARRIED [Resolution: 090730-04] On motion, the meeting returned to Open Session. MOTION: It was moved by TC and seconded by TM that the July 30th Board meeting be adjourned at 7:50 pm CARRIED [Resolution: 090730-10] Approved at the August 27th Board Meeting Original Signed by: Original Signed by: ___________________________ ______________________________ John Magill, Chair Enola Stoyle, (Corporate Secretary)

Mississauga Halton LHIN Board Meeting – August 6, 2009

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Minutes of the August 6th Special Meeting of the Board of Directors

MEETING

DATE

August 6, 2009

LOCATION:


ATTENDANCE

BOARD: John Magill, (JNM) Chair Norm Murray (NM) Brij Chadda (BC) Tim Costigan (TC). Ted Morris (TM). Enola Stoyle (EDS) Caesar Cheng (CC) Elliot Halparin (EH)

STAFF: Narendra Shah (NS) Kim Delahunt (KD) Bill Campbell (BSC) Sue Turcotte (ST) Monita O’Connor (MO) Kitty Varley, Recorder (KV)

ABSENT WITH

REGRETS: Jane McCarthy (JM)


August 27, 2009

Guests: Peter MacLeod, MASS

1.0 Call to Order

A quorum being present, the meeting was called to order at 5:00 pm with JNM in the Chair. JNM confirmed the agenda as previously provided and called for any conflicts of interest. None were forthcoming JNM noted that the purpose of the meeting was to achieve ‘Agreement in Principle’ for the framework for the MH LHIN’s IHSP Refresh.

2.0. Background and Introductions 5:00 PM

Bill Campbell, Director Health System Development provided a brief summary on the IHSP Refresh process and confirmed that the document being provided for review is not final, but rather the framework for the IHSP Refresh. Bill further advised the Board of the timelines for completion.

The 1st draft is anticipated to be completed by the end of September, followed by a validation exercise with the LHINs advisory groups, i.e. IAG (Integration Advisory Group) and the HPAC (Health Professionals Advisory Group)

A meeting will be coordinated for mid October to review the Draft with the Ministry A document is to be ready for presentation to the public by the end of November

Bill Campbell introduced Peter MacLeod from MASS to present the Citizen’s Reference Panel results regarding Local Health Priorities. Peter MacLeod reviewed MASS’ presentation and advised that meetings have been held with representatives of the Francophone community with a translated version of the presentation provided for that meeting. He also confirmed that the MH LHIN was well represented at the panel meetings in culture, ethnicity, gender and age.


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He further noted that one of the main common themes that came forward was the public’s desire for ‘Access’.

In response to a query, Mr. MacLeod confirmed that the demographic analysis used will be provided to the Board.

ACTION: Kim Delahunt/ Bill Campbell

Clarification was provided and discussion invited throughout the presentation. Mr. MacLeod’s presentation concluded at 5:40 pm 3.0 Presentation of the IHSP Refresh Framework 5:43 pm

Bill Campbell and Kim Delahunt, Manager of Communications and Community Engagement provided an overview of the IHSP Refresh and advised that, with the Board’s approval, they would review to obtain individual ‘agreement in principle’ for each priority. The Board agreed with this approach. Bill reconfirmed that the document being created is a ‘refresh’ and not a re-creation. It is very high level. Specific actions will come forward each year in detail in the Annual Business Plan (ABP)

When completed, this document will represent the MH LHIN’s direction for the next 3 years.

It was further noted that all LHINs have agreed to a consistency in format and to keep the document to 20 – 30 pages. As noted earlier, the first draft is targeted for completion in September and the final in October 2009. 3.1 Priority Setting Criteria No issues were brought forward. 3.2 Strategic Priorities and Enabling Strategies

As per the material previously provided and included in the meeting package, the Strategic Priorities and Enabling Strategies were discussed, issues raised and clarification provided as needed. The staff will consider adding Evidence Based Data for decision making to the Enabling Strategies.

3.2 was to agreed in principle 3.3 Improving Access, Quality and Sustainability of the Health System

In response to a query, NS confirmed that the inclusion of the 10% decrease under ‘Outcomes’ both with regard to ED Wait Times and ALC days, was a ministry directive. A discussion followed. Members expressed concern regarding future accountability implications which may result from stating a specific decrease. Others noted a strong target to strive towards was a positive statement to our community.

KD confirmed that this outcome would be measured by hospital and other HSP reporting.

In response to a related query regarding the LHINs responsibility for capital expenditure and their relation to services provided, Bill Campbell advised that he serves on the Capital Working Group. Although the ministry will retain responsibility for the ‘bricks and mortar’ aspect of capital expenditures, the working group is discussing programs and services.


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After further discussion regarding the inclusion of the specific 10% figure for decease in ED wait times and ALC days as an Outcome of this priority, it was recommended that the wording be revised to read, “Meeting all MLAA targets, including a decrease in ED Wait Times and ALC days. 3.3 was agreed to in principle as amended per the discussion noted above.

3.4 Prevention and Management of Chronic Conditions KD noted that the priorities as noted in the presentation were not in any particular order. 3.4 was agreed to in principle 3.5 Integrating Mental Health and Addictions Services (MH&A)

KD noted that Outcomes will be ‘fleshed out’ for the October Draft. One of the LHIN groups, SIGMHA, is currently working on this initiative.

In response to a query regarding the lack of focus on young people in our MH&A mandate, Bill Campbell advised that a project is underway within the SIGMHA group work involving transitional services for young people with MH&A issues moving from ‘youth’ to ‘adulthood’.

A provincial scorecard is expected later this month and further Outcomes around this issue will be included in the next iteration of the IHSP Refresh. KD added that an introductory page or preamble for each priority will be included in the final document. This preamble can mention further covering points for each priority. NS added that if the Legislative Committee on MH&A comes forward with some key outcomes, they too will need to be included in our final version.

After further discussion it was agreed to remove “all” from Objective 2, and add “LHIN funded”. 3.5 was agreed to in principle with the above noted revision to Objective 2. 3.6 Enhancing Seniors Health, Wellness and Quality of Life.

Under Outcomes 2, members recommended adding that LTC beds and services “as appropriate are available”, be added.

It was further recommended that either Points 4 and 6 be consolidated, or point 4 be removed. Point 5 – this point should be concluded after “ at risk”. The remainder of that point can be deleted.

EH added that we need to ensure we indicate that we want to enhance seniors’ access to optimum medical care. Other objectives will flow from that primary objective.

The word ‘Unnecessary’ will be removed and replaced with, “All”, in the first Outcome referencing a decrease in ER Visits

KD confirmed the inclusion of an introduction page for each priority and noted that the goal of enhancing seniors’ access to optimum medical care can be referenced in that section as well as a reference to overall wellness and prevention.

3.6 was agreed to in principle with the revisions as noted above.


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3.7 Strengthening Primary Health Care

It was noted that this section may focus too strongly on physicians. If an optimum number of physicians is to be included, a weighted population needs to be a part of that point.

After discussion is was decided to remove Outcome #2 and move the current Outcome #4 to be #1. Overall family healthcare needs to emphasized, not just primary care physicians.

We need to emphasize increasing the attachment of unaffiliated, complex and vulnerable patients so that family healthcare can be provided to that sector of our community. EH offered to make himself available for further clarification on these points if needed. 3.7 was agreed to in principle with the revisions noted above

3.8 & 3.9 Francophone Community and the Aboriginal Community An overview of this section was provided and a brief discussion followed.

It was decided that the first two points referencing the French Language Services Act would be removed on each priority.

In the final point, “We know”, will be replaced with, “We acknowledge”.

It was noted that there needs to be some kind of reference to indicate the two groups noted in this priority are ‘statutory’. This point can be included in the introductory page.

3.8 and 3.9 were agreed to in principle with the revisions noted above

3.10 & 3.11 Strategic Enablers and Partnerships for Collaboration Attention was drawn to the addition of Partnerships for Collaboration in this IHSP Refresh

It was also recommended that ‘Efficiencies in the System be added as part of ‘Back Office Transformation’. It was further noted that the holistic approach can be included in the introductory portion around facilitating partnerships.

3.10 & 3.11 were agreed to in principle with the revisions as noted above 3.12 eHealth A brief discussion was held. 3.12 was agreed to in principle 3.13Transportation

It was recommended that a cross reference be made between Transportation and Partnerships & Collaboration. The majority of our transportation is provided by volunteers. It was further noted that Transportation should not focus only on seniors. Others in our community require transportation due to health issues. Paragraph 2 will be re-written.

Further, in paragraph 2, “appointments or adult day…”, will be replaced with “appointments and day….”


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3.14 Back Office Transformation / Shared Service Delivery

As referenced above, this will be reworded to Efficiency in the Healthcare System and re-written to incorporate previous discussions.

3.14 was agreed to in principle pending the review of the re-write in the next draft version.

3.15 Health Human Resources This priority will look to the LHIN HPAC for advice on this priority in future. Revise the last line of the final paragraph. The word ‘physician’ will be removed. 3.15 was agreed to in principle with the noted revision. 3.16 Next Steps Next steps were reviewed.

Edits will be made to the Refresh and resent to the Board, the week of August 10th.with changes highlighted. ACTION: Bill Campbell

The revised slide deck will be sent to our Key Focus Groups for review in September.

The decision as to whether another Special Board meeting is needed will be considered after review of the next Draft edition of the IHSP Refresh.

In anticipation of the possibility of another meeting, the October 1st date on hold for a Board Education Session will be held for that purpose.

The meeting was adjourned with the next regularly scheduled Board meeting set for August 27, 2009 at 5:00 pm in the Mississauga Halton LHIN Office in Oakville. ___________________________ ______________________________ John Magill, Chair Enola Stoyle, (Corporate Secretary)


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Minutes of the August Meeting of the Board of Directors

MEETING

DATE

August 27, 2009

LOCATION:


ATTENDANCE

BOARD: John Magill, (JNM) Chair Norm Murray (NM) Brij Chadda (BC) Tim Costigan (TC). Elliot Halparin (EH) Ted Morris (TM). Enola Stoyle (EDS) Caesar Cheng (CC)

STAFF: Narendra Shah (NS) Kim Delahunt (KD) Bill Campbell (BC) Monita O’Connor Kitty Varley, Recorder (KV)

ABSENT WITH

REGRETS: Jane McCarthy


September 24, 2009

Guests:

1.0 Call to Order


2.0. Approval of the Consent Agenda and Conflict of Interest 5:02 PM The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. JNM welcomed our guests from the public and advised of the protocol for observers at MH LHIN Board meetings WBM noted a minor change to the agenda. Management Goals and Objectives as listed under Item 4, MH LHIN Operations, will be a handout, not a presentation as noted in the agenda.

MOTION: It was moved by TM and seconded by CC that the Consent Agenda be approved as amended. CARRIED [Resolution: 090827-01]

Business Arising from the August Board Meeting Minutes: No items not noted in the agenda were brought forward under Business Arising.


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JNM called members attention to The Chair’s Report as circulated with the Consent Agenda, elaborated on certain points and provided clarification as needed.

Integrity Commissioner: JNM provided a further update to that noted in the Chair’s Report, and referenced a letter received August 27th from the Commissioner’s office responding to the MH LHIN’s inquiry regarding a ‘Tip Line’ as part of the Whistle Blowing process. A copy of the Commissioner’s letter will be forwarded to the Board for information. CEO’s Evaluation and Compensation Committee: JNM advised that after discussions with the CEO regarding the weighting of the CEO’s objectives, it was determined that a meeting of the committee needs to take place prior to the regular CEO’s 6th month review to consider this CEO Scoring Objectives Proposal. ACTION: John Magill Board and Board Member Assessment: In response to a query, JNM recommended that the recently circulated Board Assessments be referred to the Governance Committee to assign responsibility to the various Board Committees for review and recommendation for appropriate Board action. The Board agreed. ACTION: Governance Committee JNM further advised that the Ministry has appointed four facilitators to be assigned to the LHINs to work with their respective Boards regarding the Board assessments. Further updates are expected following the September Chairs’ meeting.

4.0 MH LHIN Operations 5:22 PM Management Report:

WBM drew members’ attention to the Management Report included in the Consent Agenda and provided clarification as needed. A handout package was provided from Management for information. The handouts were not considered part of the formal Board meeting material, but were provided as standard management/ Board communications. An opportunity for discussion regarding the information items provided, followed.

ER Pay for Results – Performance Targets: WBM provided further information to clarify the targets and advised that this updated version had been added in the Management Report included in the meeting package and confirmed this information was representative of our 3 hospitals (4 sites). WBM and NS provided some rationale around the criteria for the funding following a member’s expression of concern regarding what was described as an inherent lack of fairness in the mathematical theory for the provision of funding. A discussion followed. Strategic Priorities: A one page management communication in support of our IHSP Refresh discussions was provided and briefly discussed.


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Management Goals and Objectives: This high level management document was provided for the Board’s information. . In response to a query on LTC placement wait times, WBM advised that we are improving, but still not yet meeting the minister’s expected targets. The LHIN will be monitoring the hospitals wait times for LTCH placements versus community placement.

LHINC Update: WBM provided members with a brief update on LHINC activities. The LHINC will allow the LHINs to interact with their respective associations at a provincial level. Both the LHINs and the government have committed to fund the LHINC equally. WBM further advised that a fulltime LHIN ED, Mario Tino has been appointed and that the first LHINC Council meeting has been held. The next major task for the LHINC will be to establish its priorities. LHINC will focus on collaboration among the LHINs to achieve consistency and share best practices to help improve LHIN effectiveness. WBM and fellow LHIN CEO Paul Huras are the LHIN CEOs on the LHINC Council. Two LHIN Senior Directors have also been appointed. The Toronto Central LHIN CEO will be an Ex-Officio member of the Council. The LSSO will also be represented with an Ex-Officio Council member.


It was moved by TC and seconded by CC that the CEO’s Certificate of Compliance dated August 20, 2009 be approved as provided in the meeting package

CARRIED [Resolution: 090827-02] 5.0 Audit & Finance Committee 6:00 PM EDS drew members’ attention to the report of the August Committee meeting as well as the other items noted on the Consent Agenda, included in the meeting package, and asked for any questions regarding the items contained therein. None were forthcoming. 6.0 Governance Committee 6:05 PM NM provided a verbal update on the activities of the committee, the August Committee meeting having been cancelled.

Staff/Board Retreat: KD provided a brief verbal update on the agenda planning and advised that she would be working with WBM on a more detailed Agenda for the September Governance Committee meeting.

Board Education Topics: KD provided an update on the proposed topics and advised that 20 surveys regarding topics have been completed. Plans are proceeding based upon those results. Members were reminded that the next session is scheduled for September 10th, with the October 1st date remaining ‘on hold’ pending the possible need for a Special Board meeting to review the IHSP Refresh. Materials for the September 10th Education Session will be sent out electronically for the benefit of those unable to attend in person.. ACTION: Kim Delahunt Governance to Governance G2G Session-September 30th: KD confirmed we currently have more than 70 registrations, of which 60% are members of our providers’ respective Boards. All three of our hospitals are represented.


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7.0 Community Nominations Committee 6:20 PM JNM provided an update in the absence of the Committee Chair. JNM advised he will be working with the Minister’s Office to encourage the timely flow of LHIN Board appointments.

8.0 Integration Activities 6:25 PM NS drew members’ attention to the section in the Management Report on Integration Activities and further noted the tables included in the meeting package. These tables are a high level summary stemming from our ABP and represent the items on which the LHIN is focusing. The Board was advised that regular updates will be provided as part of the Management Report with a more fulsome report to be provided on a quarterly basis. 9.0 Closed Session 6:32 PM MOTION:

Pursuant to s.9(5) of the Local Health Integration Act, 2006, it was moved by TC and seconded by TM that the August 27th Mississauga Halton Board Meeting move into Closed Session.

CARRIED [Resolution: 090827-03] On motion, the meeting returned to Open Session. MOTION: It was moved by BC and seconded by TM that the August 27th Board meeting be adjourned at 8:20 pm CARRIED ___________________________ ______________________________ John Magill, Chair Enola Stoyle, (Corporate Secretary)

Mississauga Halton LHIN Board Meeting – September 24 2009

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Minutes of the September Meeting of the Board of Directors

MEETING DATE

September 24, 2009

LOCATION:


ATTENDANCE BOARD: John Magill, (JNM) Chair Brij Chadda (BC) Tim Costigan (TC). Elliot Halparin (EH) Caesar Cheng (CC) Jane McCarthy (JM)

STAFF: Bill MacLeod, (WBM) Narendra Shah (NS) Bill Campbell (BC) Monita O’Connor Kitty Varley, Recorder (KV)

ABSENT WITH REGRETS: Ted Morris (TM). Enola Stoyle (EDS) Norm Murray (NM)


October 29, 2009

Guests:

1.0 Call to Order


2.0. Approval of the Consent Agenda and Conflict of Interest 5:00 PM The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. No members of the public were in attendance

MOTION: It was moved by CC and seconded by JM that the Consent Agenda be approved as circulated CARRIED [Resolution: 090924-01]

Business Arising from the August Board Meeting Minutes: No items not noted in the agenda were brought forward under Business Arising.


JNM called members attention to The Chair’s Report and relevant attachments as circulated with the Consent Agenda, elaborated on certain points and provided clarification as requested. JNM drew members attention to their copy of the Guide to Good Governance, September 2009, referenced in Chair’s Report and provided as a handout in their meeting package. Electronic versions were forwarded to those members dialing in for the meeting. JNM noted that the Governance guidelines contained therein are now mandated.

JNM has reviewed the Governance Manual and advised that it draws both from the OHA and the PAS, and further reminded the members that on September 29th the Minister will be speaking to the LHIN Board and Sr. Team. JNM referenced the revised CEO’s Cert of Compliance copied in the Chair’s Report and also the proposed Declaration of Compliance from LHIN Chairs to the Minister. The Chairs have approved this compliance document in principle and are awaiting comments from the LHIN Legal Counsel, due in early October, after which time a final Declaration of Compliance will be confirmed.


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4.0 MH LHIN Operations 5:16 PM Management Report:

WBM drew members’ attention to the Management Report included in the Consent Agenda and provided clarification as needed. An opportunity for discussion, regarding the information items provided, followed with both WBM and NS elaborating on the items noted in the report. NS added that a Board Education session is planned for November 5th regarding the new Long-Term Care Regulations. WBM noted that we are now beginning a process for the two year accountability agreements with our hospitals. The current agreements expire in March 2010. There are challenges in this process as the ministry has not yet confirmed the multi-year planning targets. This makes it difficult for the hospitals to submit their own plans. In response to a query from member JM regarding an acronym in the report, WBM confirmed OLIS referred to the Ontario Lab. Information System. JM further inquired about the name of the physician who is the Lead from the Family Health Teams in eHealth Ontario. Management will provide. ACTION: Bill MacLeod WBM advised that the Diversity Plan which was to have been presented to the Board this month is complete, but prior to a full Board presentation, a review needs to take place involving the Board members who have had input into this plan. The Plan will be presented to the Board at the October meeting ACTION: Bill MacLeod / Kim Delahunt


It was moved by CC and seconded by JM that the CEO’s Certificate of Compliance dated August 20, 2009 be approved as provided in the meeting package

CARRIED [Resolution: 090924-02] 5.0 Audit & Finance Committee 5:27 PM CC, in the absence of the Committee Chair, drew members’ attention to the report of the September Committee meeting as well as the other items noted on the Consent Agenda, included in the meeting package, and asked for any questions regarding the items contained therein. CCAC Service Maximum Funding:

CC brought forward the CCAC Service Maximum Funding for approval as recommended by the Audit and Finance Committee and invited questions.

MOTION:

It was moved by CC and seconded by BC that the Services Maximum Funding as recommended by the Audit and Finance Committee and with reference to the ministry letter and BN included in the meeting package, be approved.



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6.0 Governance Committee 5:33 PM JNM drew members’ attention to the report of the September Committee meeting and work plan as included in the Consent Agenda. JNM added that, as of today, we have registered 115+ for the September 30th G2G session and that this registration was representative of all our HSP sectors. 7.0 Community Nominations Committee 5:40 PM JM provided a verbal update. JM is working towards completing the documentation the process used by MH LHIN’s in its recruitment of new Board members and will be soliciting comments from all those members who participated in the interview process to ensure all points are covered. JM will also ensure that recommendations from the new Governance Manual referenced in the Chair’s report are included. . Other points being reviewed by JM and her committee will be the orientation that needs to be put in place for new members and plans to ‘keep them interested’ during the period in which our Board Member recommendations are being considered. JNM confirmed that he will be conferring with the Minister’s Office in early October to try to determine the status of our recommendations. . 8.0 Integration Activities 5:46 PM No further items other than those in Mgmt. Report were brought forward 9.0 IHSP Review 5:47 PM NS reviewed the IHSP draft with the Board and noted that this document captures both the ministry’s and the LHIN’s priorities. Questions and discussion were invited. The document was reviewed by Section with comments and recommendations noted by staff. A general comment that was made throughout was that the document needed to be simplified somewhat from a language perspective to ensure comprehension by all members of our community. Some sections were recommended for re-writes. After further discussion, the Board and Staff agreed that sufficient input had been provided and received to enable staff to prepare the next Draft of the IHSP Refresh The ‘Hold’ for a Special Board Meeting on October 1st was cancelled. Absent Board members will be polled for their comments on the next iteration of the Draft, which will take into account all comments and recommendations put forward at the meeting. ACTION: Bill MacLeod 10.0 Closed Session 7:20 PM

MOTION: It was moved by BC and seconded by JM that the September 24th Mississauga Halton Board Meeting move into Closed Session.

CARRIED [Resolution: 090924-04] The Meeting continued as a Closed Session for the Board and CEO


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On motion, the meeting returned to Open Session. MOTION:

It was moved by BC and seconded by EH that the September 24, 2009 Board meeting be adjourned at 8:15 pm

CARRIED _________________________ _______________________________ John Magill, Chair Enola Stoyle

Mississauga Halton LHIN Board Meeting – October 29, 2009

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Minutes of the October Meeting of the Board of Directors

MEETING DATE

October 29, 2009

LOCATION:


ATTENDANCE BOARD: John Magill, (JNM) Chair Brij Chadda (BC) Tim Costigan (TC). Elliot Halparin (EH) Caesar Cheng (CC) Jane McCarthy (JM) Ted Morris (TM). Enola Stoyle (EDS) Norm Murray (NM)

STAFF: Bill MacLeod, (WBM) Narendra Shah (NS) Bill Campbell (BC) Monita O’Connor Kim Delahunt Kitty Varley, Recorder (KV)



November 26, 2009

Guests: Joe Bornstein, Amanda Pieris and Valerie Grdisa, KPMG, a delegation from HHS and representatives from the ‘Friends of Milton Hospital’

1.0 Call to Order


2.0. Approval of the Consent Agenda and Conflict of Interest 5:06 PM The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. JNM greeted our guests from the public and advised them of the protocol for LHIN Open Board Meetings

MOTION: It was moved by TM and seconded by BC that the Consent Agenda be approved as circulated CARRIED [Resolution: 091029-01]

Business Arising from the August Board Meeting Minutes: None was brought forward. .


JNM called members attention to The Chair’s Report and relevant attachments as circulated with the Consent Agenda, elaborated on certain points and provided clarification as requested. 4.0 MH LHIN Operations 5:10 PM 4.1 Management Report:

WBM drew members’ attention to the Management Report included in the Consent Agenda and provided clarification as needed WBM provided some verbal background and noted that ‘treatment time’ may replace ‘wait time’ terminology in further reports and updates.


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4.2 Capital Projects – Milton Project Update

Materials, as previously provided and included in the meeting package provided the basis for the discussion and the Milton Project update. As part of the LHIN’s evolving role in Capital Planning, the ministry has requested the LHIN provide comments on the programs and services being offered and how they are integrated with other services within the LHIN. This is outlined in the ministry letter of May 8, 2009, to the HHS Board Chair, included in the meeting package. WBM reviewed the presentation included in the meeting package “Assessment of Milton District Hospital Redevelopment Plan, dated October 21, 2009. In response to a query, WBM confirmed that Burlington will be serviced by the proposed hospital redevelopment and further added that the MH LHIN has met with the HNHB LHIN to confirm that all original assumptions remain in place regarding the expansion of the two HHS hospitals (Oakville and Milton)

During a discussion on the role of Market Share in the review process, EH recommended the LHIN remove the services not being provided by the hospital in order to equalize the comparisons and added that the family physician’s referral plan will play a role in determining market share . WBM agreed this will be important as we move forward and noted that a major Acute Services Study is underway by the LHIN which will address these recommendations. This study is 8 – 12 months from completion and the urgency of the need to move this project forward indicates some action is needed prior to the study’s completion During the coming month additional due diligence and consultation will take place, with the goal of bringing a final recommendation back to the Board for approval at the November Board meeting.

ACTION: Bill MacLeod & LHIN Sr. Management Team

After discussion a motion was put forward. EH declined to take part in the vote due to a potential conflict of interest. MOTION:

It was moved by NM and seconded by TC that the LHIN move forward on the proposed ‘Next Steps’ as outlined on page 58 of the Presentation dated October 21, 2009. CARRIED [Resolution: 091029-02]

JNM, as Board Chair advised that he will pursue this with the Minister of Health and the Minister of Infrastructure to determine how readily this can move forward and how we can avoid further delays. JM added an understanding of the services that would be most valuable to the respective areas would be useful and should drive our recommendation to the ministry. This information should be part of the staff’s recommendation to the Board.

ACTION: Bill MacLeod & LHIN Sr. Management Team

4.3 Health Equity Plan – For Information

Due to meeting time constraints and approval items still to review, it was agreed to hold 4.3 Health Equity Plan over for the November meeting


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It was moved by NM and seconded by CC that the CEO’s Certificate of Compliance dated October 22, 2009 be approved as provided in the meeting package


JM questioned the removal of Health and Safety from the CEO’s Certificate of Compliance. JNM agreed this was an oversight and will ensure it is included in future Certificates.

5.3 MH LHIN Operating Budget – 2009/10

5.0 Audit & Finance Committee 6:20 PM BC, as Acting Chair for the October Committee meeting, drew Members attention to the Consent Agenda Item list which noted those items previously provided in the meeting package, for Information, and invited questions. BC further noted the four items being recommended by the Committee for Board approval. With reference to the four approval items as noted below, BC recommended all four items be combined in one motion for approval purposes. The Board agreed. 5.1 Revenue Acceptance – CCAC Rehabilitation

5.2 Revenue Acceptance – Trillium Health Centre PCOP (Post Construction Operating Costs)

5.4 MH LHIN eHealth Budget – 2009/10

MOTION:

It was moved by BC and seconded by TC that items 5.1, 5.2, 5.3 and 5.4 as noted above and outlined in the Briefing Notes included in the meeting package be approved as provided.

CARRIED [Resolution: 091029-04] 6.0 Governance Committee 6:45 PM No questions were brought forward regarding the Governance material provided in the Consent Agenda. 7.0 Community Nominations Committee 6:48 PM JM provided an update on the committee’s activities and advised she plans to consult with members who took part in the OIC appointment recommendation. She has also had conversations with her counterparts on the other LHIN Boards. These consultations will help us move towards a more consistent process across all LHINs JM further noted that concern was expressed by the LHINs consulted, that as yet, no robust orientation or transition planning for new Board members has been put in place. .8.0 Integration Activities – Standing Item 6:55 PM NS reviewed the two Voluntary Integrations being brought forward from Management for the Board’s review and approval, and provided any clarification as needed. Detailed Briefing Notes were provided in the meeting package to assist members in their consideration of the requests. NS noted that “.. subject to approval of ministry funding”, will be added to the recommended motion being put forward. 8.1 Halton Healthcare Services (HHS) and Wyndham Manor for the provision of peritoneal dialysis. 8.2 Credit Valley Hospital and Leisureworld for the provision of peritoneal dialysis


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In a response to a query, it was confirmed that the cost of supplies for the peritoneal dialysis in the respective homes will be covered by the regional care centre’s budget. After further discussion, the Board agreed to combine approval of both voluntary integrations in one motion. . MOTION:

It was moved by BC and seconded by NM that the two Voluntary Integrations as noted above and outlined in the Briefing Notes included in the meeting package, subject to ministry funding, be approved.

CARRIED [Resolution: 092910-05] . 9.0 Health Information Management 7:12 PM WBM recommended that due to time constraints and the Closed Session items yet to be reviewed, the Oversight Structure as included in the meeting package and noted on the agenda as 9.2, will be deferred to the November meeting. The Board agreed. WBM called for questions regarding material provided in the meeting package regarding 9.1. Andrew Hussain (AH), MH LHIN CIO and eHealth Lead provided an update on the IS/IM/IT strategy using the presentation included in the meeting package as a base for discussion. AH noted that eHealth strategies are all mapped back to the provincial strategies. AH further noted, in response to a query, that eHealth Ontario is only dealing with the Diabetes Registry, not strategy implementation. WBM advised that proposals are now being considered for the identification of a Regional Coordinating Centre for Diabetes, within our LHIN. This centre will be the Lead for implementing the Diabetes strategy. EH offered to make himself available to staff to discuss any aspects of the strategy. 10.0 Closed Session 7:25 PM

MOTION: It was moved by NM and seconded by CC that the October 29th Mississauga Halton Board Meeting move into Closed Session.

CARRIED [Resolution: 091029-06] On motion, the meeting returned to Open Session. MOTION:

It was moved by JM and seconded by NM that the October 29, 2009 Board meeting be adjourned at 8:50 pm

CARRIED ORIGINAL SIGNED BY: ORIGINAL SIGNED BY: ___________________________ ________________________________ John Magill, Chair Enola Stoyle, Secretary

Mississauga Halton LHIN Board Meeting – November 26, 2009

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Minutes of the November Meeting of the Board of Directors

MEETING

DATE

November 26, 2009

LOCATION:

The Waterside Inn 15 Stavebank Road South Mississauga ON

ATTENDANCE

BOARD: John Magill, (JNM) Chair Brij Chadda (BC) Tim Costigan (TC). Caesar Cheng (CC) Jane McCarthy (JM) Ted Morris (TM). Enola Stoyle (EDS) Norm Murray (NM)

STAFF: Bill MacLeod, (WBM) Narendra Shah (NS) Bill Campbell (BC) Kitty Varley, Recorder (KV)

ABSENT WITH

REGRETS: Elliot Halparin (EH)


January 7, 2010

Guests:

1.0 Call to Order


2.0. Approval of the Consent Agenda and Conflict of Interest 5:02 PM The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. JNM greeted our guests from the public and advised them of the protocol for LHIN Open Board Meetings

MOTION: It was moved by CC and seconded by TM that the Consent Agenda be approved as circulated CARRIED [Resolution: 091126-01]

Business Arising from the August Board Meeting Minutes, not covered in the Agenda as provided: No items were brought forward. .


JNM called members’ attention to The Chair’s Report as circulated with the Consent Agenda, elaborated on certain points and provided clarification as needed. JNM elaborated on the role of the LHIN Chairs’ representative, the Chair of Chairs, as referenced in his report. 4.0 MH LHIN Operations 5:14PM 4.1 Management Report:

WBM drew members’ attention to the Management Report included in the Consent Agenda and provided clarification as needed


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WBM clarified the reference to wait times referenced on page 1 of the Mgmt. Report and the criteria for ‘Actual Performance’. WBM confirmed that the CT scanners do operate with extended hours, but only to the extent to which they are funded. WBM noted that our wait times funding has been reduced this year, so it is difficult to fund such services to operate on a 24/7 basis. WBM clarified the reasoning behind not indicating our performance in ‘red’ on the spreadsheet provided. He confirmed that although MH LHIN is not at our ministry ‘target’, we are still inside our required ‘corridor of performance’. It was requested that in future reports the ‘corridor’ be noted on the spreadsheet, for clarification. ACTION: Narendra Shah

4.2 Equity Plan

The MH LHIN Equity Plan was provided for Information as part of the Consent Agenda. BC noted that he had provided a presentation for the Board’s information regarding the MH LHIN Equity Plan. BC further noted that his presentation had been posted on the LHIN’s website, but advised that the presentation was in draft format and requested it be removed from the website so that it can be refined to a final format suitable for posting. ACTION: Kim Delahunt BC added that the MH LHIN needed a robust community engagement plan with the Board fully engaged. When the Board and the community are engaged, diversity will flow naturally. It was recommended that this topic be put on the January 28th meeting agenda for a fulsome discussion. The Board agreed. Management to prepare a presentation which will act as a catalyst for this discussion. ACTION: Kim Delahunt. TC recommended a Board Education session prior to the Board discussion. Members agreed this would be helpful. Such a session will be schedule for January or February and the timing of the Board agenda topic will adjust in keeping with the scheduling of such an education session. ACTION: Kim Delahunt/ Bill MacLeod JNM added that diversity is more than cultural, ethnic or gender specific. JM also offered to assist in the preparation for this Board discussion. It was confirmed that Kim Delahunt, Manager of Communications and Community Engagement would be the staff Lead on this initiative.

4.3 Capital Projects

Milton Redevelopment Project Attention was drawn to the Briefing Note included in the meeting package. After a review of the BN and a brief discussion, a motion was brought forward. WBM noted the LHIN has had discussions with the ministry’s capital planning group as well as HHS planning staff regarding the Milton project. Members were advised that a review around population growth areas has been completed. NM noted that there should be a synergism between HNHB and the MH LHIN regarding redevelopment at the Joseph Brant Hospital in Burlington and any redevelopment in the HHS region.


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WBM advised that more detailed discussions would be held when functional planning for this project begins. Bed capacity will be addressed in the functional planning stage as well. WBM further noted that historical utilizations and population growth areas were considered in the recommendation and proposed motion, as outlined in the Briefing Note included in the meeting package. MOTION:

It was moved by TM and seconded by EDS that, whereas; There is a need for urgent attention to expand ambulatory care services,

maternal/newborn services, emergency services and some general medical/surgical services;

The current Milton District Hospital facility is outdated, undersized, reaching the end of life and incapable of supporting modern-day services;

It is critical the Milton District Hospital’s redevelopment be considered a high priority of the Ministry for moving to the next stage of functional planning;

That the MH LHIN Board endorse the redevelopment of the Milton Hospital to support increased ER, Ambulatory Care and related inpatient obstetrical and medical/surgical capacity with the understanding that;

A robust review and assessment occur at the Functional Program Stage of capital development by HHS and the LHIN on the current market share assumptions and estimates; taking into account such factors as population growth, aging, and the impact of current capital investments at other MHLHIN hospitals;

Clinical programs and services including a view to considering clinical integration opportunities between Milton Hospital, the new Oakville Hospital site and other MH LHIN Hospitals;

The hospital implement a more fully integrated medical staff with the North Oakville site for the provision of specialist consultation at the Milton Hospital


4.3 Credit Valley Hospital

Attention was drawn to the Briefing Note included in the meeting package. After a review of the BN and a brief discussion, a motion was put forward.

MOTION:

It was moved by CC and seconded by NM that the MH LHIN Board endorse the Credit Valley Hospital’s expression of interest in the expansion of the operating rooms and critical care capacity onsite as per the BN and supporting materials enclosed with the meeting package.

CARRIED [Resolution: 091126-03] . 4.4 Integration Health Service Plan (IHSP) Attention was drawn to the Briefing Note included in the meeting package. A brief discussion followed.

The IHSP having been previously circulated for the Board’s review, WBM recommended the Board consider a motion of the approval of the IHSP.

MOTION: It was moved by TM and seconded by TC that the IHSP be approved as presented. CARRIED [Resolution: 091126-04]


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4.5 CEO Certificate of Compliance

WBM noted that at the January meeting, the Chair will present an additional piece to the LHIN compliance, a confirmation from the Board Chair as the representative of the MH LHIN Board.

MOTION:

It was moved by TC and seconded by NM that the CEO Certificate of Compliance be approved as presented. CARRIED [Resolution: 091126-05]

EDS expressed some concerns regarding Internal Controls and will provided JNM with further details for his consideration, in a separate communication.

The Board congratulated NS and staff on the completion of the IHSP.

5.0 Audit and Finance Committee 6;01 pm Consent Agenda Items per the Consent Agenda item list were noted and questions invited. None were forthcoming. Two items were brought forward from the Audit and Finance Committee for consideration for Board approval

5.2 PHABIS (Peel Halton Acquired Brain Injury Services) The Briefing Note included in the meeting package provided the basis for a brief discussion.

5.3 Sheridan Villa

The Briefing Note included in the meeting package provided the basis for a brief discussion. After discussion, members agreed to consider 5.2 and 5.3 under one motion.

MOTION: It was moved by TC and seconded by JM that the Board approve the transfer of funds as noted in the Briefing Note included in the meeting package and noted on the agenda as 5.2 and 5.3, be approved as presented. CARRIED [Resolution: 091126-06]

6.0 Governance Committee 6:04 pm The Committee Chair noted the report and work plan from the November meeting as provided in the Consent Agenda and invited questions. NM drew members attention to the Task Assignments as referenced in the meeting report which was provided in the Consent Agenda, for information, and distributed copies of the KPMG Board Chair Assessment which was referenced in that report. NM asked members to review the assignments and advise him directly of any comments or concerns they may have. 7.0 Community Nominations Committee 6:07 pm The Committee Chair invited questions regarding the committee’s activities. JNM updated members on his recent meeting with the Minister and her staff. 8.0 Integration Activities 6:12 pm This is a Standing Item on the Board’s agenda. NS noted that a further update would be provided during the Closed Session portion of the meeting.


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NS added that Halton Health Services has taking on the role of hosting our Diabetes Coordinating Centre. WBM noted that the prime effort of this centre will be to move forward on all diabetes screening activities in our LHIN. The following notes were brought forward from Closed Session. Voluntary Integration – Trillium Health Centre and ErinOakids

Trillium has prepared an initial analysis to divest Trilliums’ Autism Intervention Services Program to ErinOakids to integrate these services for the region.

In addition to the information provided in the meeting package, a verbal update on this integration activity was provided by WBM and NS. This may be reported in the Open Session minutes now as the personnel issues originally designating it to Closed Session, have been resolved. A letter of congratulations will be sent from the MH LHIN

ACTION; John Magill/Bill Macleod

9.0 Long-Term Care Service Accountability Agreement (LSSA) 6:20 pm Attention was drawn to the background materials provided in the meeting package. A brief discussion followed after which a motion was put forward. Clarify with Bill. JNM will send a copy of the LSSA to board once the template is approved. MOTION:

It was moved by CC and seconded by NM that the Board authorize the Chair and the CEO of the MH LHIN to approve the Long-Term Care Service Accountability Agreement Template Draft version once it is recommended by Legal Counsel, and;

That the Chair and CEO of the MH LHIN be authorized to execute subsequent service accountability agreements with health service providers in the long-Term Care Home sector, using the final version of the Long-Term Care Service Accountability Agreement Template.

CARRIED: [Resolution: 091126-07] 10.0 Closed Session 6:33 pm

MOTION: It was moved by EDS and seconded by JM that pursuant to s9(5) of the Local Health Integration Act of 2006, the November 26th Mississauga Halton Board Meeting move into Closed Session.


It was moved by EDS and seconded by TM that the November 26, 2009 Board meeting be adjourned at 7:10 pm, with the next regularly scheduled Board meeting to occur on January 7, 2010. This will be the December Board Meeting. The regular monthly Board meeting will be held on January 28, 2010

CARRIED Original Signed by: Original Signed by: ___________________________ _________________________________ John Magill, Chair Enola Stoyle

Mississauga Halton LHIN Board Meeting – January 7, 2010 (December Board Meeting)

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Minutes of the December Meeting of the Board of Directors

MEETING

DATE

January 7, 2010

LOCATION:

MH LHIN Offices 700 Dorval Drive, Suite 500 Oakville ON L6K 3V3

ATTENDANCE

BOARD: John Magill, (JNM) Chair Brij Chadda (BC) Tim Costigan (TC). Jane McCarthy (JM) Ted Morris (TM). Enola Stoyle (EDS) Norm Murray (NM)

STAFF: Bill MacLeod, (WBM) Narendra Shah (NS) Bill Campbell (BC) Kim Delahunt Monita O’Connor Kitty Varley, Recorder (KV)

ABSENT WITH

REGRETS: Caesar Cheng


January 28, 2010

Guests:

1.0 Call to Order


2.0. Approval of the Consent Agenda and Conflict of Interest 5:00 PM The Chair called for declarations of conflict of interest in respect of any matters in the Agenda as circulated with the Consent Agenda. None were forthcoming. Community Nomination’s Committee Chair, JM requested her report be moved to Closed Session. The Chair and Board agreed.

MOTION: It was moved by BC and seconded JM by that the Consent Agenda be approved with the Agenda being amended as noted above. CARRIED [Resolution: 100107-01]

Business Arising from the November Board Meeting Minutes, not covered in the Agenda as provided: No items were brought forward. .


JNM called members’ attention to The Chair’s Report as circulated with the Consent Agenda, elaborated on certain points and provided clarification as needed. After a brief discussion on the time allotment for the Health Equity / Diversity plan, WBM confirmed that it was put on the current agenda as information, with approval to follow at a future meeting.


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4.0 MH LHIN Operations 5:06PM 4.1 Management Report:

WBM drew members’ attention to the Management Report included in the Consent Agenda and provided clarification as needed. In response to a query, WBM confirmed that the MH LHIN has just under $10M for Aging at Home proposals and further confirmed that management plans to review the Board’s decision making criteria and has had some discussions on this topic with Sr. Staff.. Members noted the value of having Board members meet with our HSPs regarding the IHSP. It is also a valuable opportunity to advise our HSPs on the LHIN’s activities and direction. It was suggested this potential opportunity can be offered to our HSPs along with the delivery of the refreshed IHSP.

4.2 CEO Certificate of Compliance: MOTION:

It was moved by NM and seconded by TM that the CEO Certificate of Compliance as provided in the meeting package be approved as provided. CARRIED [Resolution: 100107-02]

5.0 Audit and Finance Committee 6:16 pm Consent Agenda Items per the Consent Agenda item list were noted and questions invited. None were forthcoming. One item was brought forward from the Audit and Finance Committee for consideration for Board approval

5.1.Aging at Home HSP Reallocation per the Briefing Note included in the meeting package TC provided an overview of the reallocation, further to the BN provided in the meeting package. BC added that the parties involved are in full agreement with the reallocation being recommended.

MOTION: It was moved by BC and seconded by NM that the Board approve the Reallocation of the Aging at Home funding as provided in the meeting package. CARRIED [Resolution: 100107-03]

5.2 Special Audit and Finance Committee Meeting.

EDS advised members that a Special Audit & Finance Committee was scheduled as a result of the FIPPA request brought forward at the December Committee meeting and some issues resulting from the FIPPA inquiry.

EDS further advised that as a result of the committee’s concerns and the discussions held at the Special Committee meeting, certain internal controls have been put in place and a number of reviews have been undertaken by Senior Management. A report of these reviews and other issues discussed at the Special Committee meeting will be brought forward to the committee at the January committee meeting with a subsequent report to be provided to the Board at the January 28th meeting.

Following are some, but not all of the undertakings being conducted:

A review of the current delegation of authority A review of the procurement policy as it relates to single source contracting. A review of any current single source contracts and relating documentation


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What procedures should be created or reviewed which will ensure proper procurement guidelines are followed.

What procedures, actions or policies will enable the LHIN to identity weaknesses in our procurement protocols.

EDS confirmed that the Audit and Finance committee is now confident that appropriate actions and controls have been put in place.

MH LHIN CEO will be providing a report to the committee at the meeting in January. ACTION: Bill MacLeod . The Audit and Finance Committee will also be reviewing some of the discretionary items in the procurement

guidelines, i.e. ‘urgency’, as a criterion for sole source contracting. What does our Board consider ‘urgent’? 6.0 Governance Committee 6:34 pm The Committee Chair noted the report and work plan from the December meeting were included in the Consent Agenda and invited questions.

6.1 Draft Board Work Plan – the Board Chair has worked diligently to finalize the draft work plan. The plan has now been forwarded to each committee chair to review how their respective committees can align their activities to support the plan. A report on this activity is hoped to be available for the February Governance committee meeting.

6.2 Committee’s Review of Position Guidelines. The position guidelines have been through one committee review. Resulting revisions will be discussed at the January committee meeting. As there may be further changes to the guidelines resulting from the various committees’ work plan review, it is estimated the guidelines will be brought forward at the February Board meeting.

JNM added for member’s information that we anticipate the orientation of prospective new Board members will be initiated within the coming weeks. 6.3 Survey Results – Board Retreat. NM recommended that the Board should focus on ‘next steps’, in terms of taking our aggressive plans as noted at the Retreat, into our Annual Business Plan. WBM concurred and added that the next step will be to bring all recommendations into alignment with the ABP and create a 2 year Goal Statement. NM also encouraged board members to provide concrete examples and recommendations on how we can improve the 2010 retreat.

JNM further advised members that the Chair of the MH CCAC has invited our LHIN to take part in their strategic planning session at the end of February. Dates of upcoming meetings to be forwarded as soon as available.

7.0 Community Nominations Committee 6:42 pm As noted in 2.0 above, the Community Nominations Committee report has been moved into closed session 8.0 Integration Activities 6:43 pm This is a Standing Item on the Board’s agenda. No new activities were brought forward at this time.


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9.0 Health Equity Plan 6:44 pm KD confirmed that the materials related to the Health Equity Plan were provided in advance so all could review and be prepared for a fulsome discussion on the plan being presented. KD provided an overview. KD noted that, in response to Board direction, this draft plan focused more on health equity than on cultural diversity. Disparities in our system need to be indentified and reduced and equal opportunities for good health for all need to be provided. A discussion followed with recommended revisions noted by staff and highlighted below

Metrics and measurement need to be considered to ensure our direction is clear and we can guide and monitor our progress towards achieving our goals.

The LHIN must lobby for improvement in health inequities, but we need to also ensure the solutions being recommended, match the problem.

Diversity is achieved by engaging the community. Diversity is a part of the overall Health Equity Plan, but the profile of that Diversity needs to be raised in the plan. It was recommended including Diversity in the plan’s preamble and motivation. The ‘tone’ of the plan needs to be revisited so it is not permissive. The plan needs to include timelines and metrics Under “What Can the MH LHIN Do?” revisit the wording to make reference to our diverse communities. Suggested, specific wording revisions were noted by staff.

A discussion followed regarding the inclusion of Health Equity as part of our Mission, Mission, Value statements and the use of the word ‘diverse’ within the plan. WBM noted, regardless of our philosophies, inequities exist. We therefore need to incorporate corrective actions into our decision making processes As a result of further discussion, staff will incorporate the recommended revisions and return to the Board for review and approval at the January Board Meeting. ACTION: Kim Delahunt /Bill MacLeod 10.0 Closed Session 7:10 pm

MOTION: It was moved by TC and seconded by NM that pursuant to s9(5) of the Local Health Integration Act of 2006, the January 7th Mississauga Halton Board Meeting move into Closed Session.


It was moved by JM and seconded by TM that January 7th Board meeting be adjourned at 7:25pm, with the next regularly scheduled Board meeting to occur on January 28, 2010.

CARRIED Original Signed by Original Signed by ___________________________ ________________________________________ John Magill, Chair Enola Stoyle

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