Ontario Health Teams – Collaborative Models

The Ontario Ministry of Health and Long-Term Care is seeking applications from health care organizations to form Ontario Health Teams (OHTs). Successful applicants that meet the readiness requirements will be designated by the Minister as “integrated care delivery systems” under Section 29 of the Connecting Care Act (Bill 74). Designated OHTs will be prioritized for future investments and be eligible for performance-based financial incentives.

The vision is for every patient in Ontario to be served by an OHT that provides a continuum of coordinated care.

Every OHT needs to establish its own leadership, accountability and governance model. There is no prescribed right or wrong way to set up an OHT. The model you choose needs to work for your organizations. It needs to ensure that there is a mechanism to make collaborative decisions that will support the continuum of care envisioned by the MOHLTC. The model will likely evolve over time – in initial stages the participating organizations will likely want to maintain their autonomy while coordinating service delivery and decision-making. This model may evolve, as the organizations work together and better understand each other’s operations and services, to more integrated management and/or governance models.

We can help.

We have worked for years with health care organizations on many different types of collaborative models that span the spectrum from complete integration to complete autonomy with coordinated decision-making. These models include variations on the following:

  • collaborative governance models that facilitate shared boards or shared committees that implement joint decision-making and allow for coordinated financial and clinical oversight
  • alliance arrangements that allow separate boards or separate committees to work together to make joint decisions
  • arrangements that facilitate efficiency through sharing of scarce resources – those resources may include management resources, back-office services or IT services (including sharing of an electronic medical record)
  • complete integrations through merger or amalgamation.

We would be happy to work with you to review the options that are available, how they may evolve, and what solution would best suit your potential OHT. We can also help to ensure that whatever model you establish reflects best governance and oversight practices to manage the financial and quality risks (and opportunities) associated with collaborative service delivery.

We can also document your model in a formal legal agreement that will demonstrate your readiness to move forward as a designed OHT.

Please contact either Kathy O’Brien (kobrien@ddohealthlaw.com) or Michael Gleeson (mgleeson@ddohealthlaw.com) for a discussion about next steps.

Bill 74 is Out of Committee

Bill 74 – The People’s Health Care Act, 2019 – has been reported out of Committee and was ordered for third reading yesterday.

There are very few changes – the handful of significant changes are summarized below:

  • Big changes for LTC homes. Sections 33(2)(d) and (e) are changed to remove a prohibition on the Minister issuing a specific type of integration order to municipalities and boards of management that are LTC licensees and to stand-alone LTCs that are not part of another type of health service provider. The Minister may now issue an integration order to these LTC homes to “co-ordinate services with or partner with” another person/entity funded by Ontario Health. In the first draft these types of LTC homes were protected from the issuance of this type of integration order.
  • Facilitated integration decisions. The Minister can issue a “facilitated decision” order only after the parties reach an agreement with respect to the integration – this is an improvement.
  • Appointment of supervisor. The Bill clarifies that the Minister may only appoint a supervisor over a health service provider that is funded by Ontario Health.
  • Indigenous health. In a couple places there’s a positive obligation on the Minister to engage with Indigenous communities before specifying the planning entities for Indigenous health that it will formally engage with.
  • Equity. Generally, in the background, there is a new commitment to equity and equitable health outcomes.

 

If you have any questions, please contact Kathy O’Brien @ kobrien@ddohealthlaw.com.

The Broader Public Sector Interim Measures – Mandatory or Voluntary Compliance?

The Interim Measures, effective March 18, 2019, were released by the Ontario Government to centralize the Ontario Public Service and broader public sector (“BPS”) purchasing and supply chains. It is part of the government’s plan to transition to a centralized procurement model and is applicable to hospitals, school boards, universities, colleges and post-secondary institutions, children’s aid societies and shared services organization/group purchasing organizations.

This blog focuses on the impact of the Interim Measures on BPS organizations, based on information available to us.

What are the Interim Measures?  

New procurements of goods and services valued at $25,000 or higher are subject to the Interim Measures, which request BPS organizations to use an existing Vendor of Record (“VOR”) arrangement where possible and appropriate; and ensure all new contracts have a term not exceeding two years, including any extensions. “New procurement” is broadly defined and includes any new RF[X], new limited tendering, new piggyback or extension of any existing contract beyond the current term.

Does your organization have to comply with the Interim Measures?

Funding ministries will inform BPS organizations on whether compliance with the Interim Measures is mandatory or voluntary. In order for it to be mandatory, there must be a legislative authority for the funding ministry to provide direction to the BPS organization – and the funding ministry must clearly exercise that legislation authority. For voluntary compliance, there is either no legislative authority available or legislative authority has not been exercised.

So, how will your organization know if compliance with the Interim Measures is mandatory or not? You will have to ask yourself the following questions:

  • What does your cover letter from the funding ministry say?
    • Check the cover letter and materials provided by your funding ministry to see if it explicitly states whether the requirements are mandatory or voluntary. The covering letter may state that compliance is expected as opposed to required.
    • Does the cover letter refer to any legislative authority to issue a directive to your organization?
  • Does your Ministry have legislative authority to provide directive to your organization to comply with the Interim Measures?
    • For example, for hospitals, the Interim Measures are not mandatory as the Ministry of Health and Long-Term Care does not have the legislative authority to issue procurement directives to the hospitals. Only the Management Board of Cabinet has the authority under the Broader Public Sector Accountability Act.

So, if compliance is voluntary, what does that mean for your organization? Even if the Interim Measures are voluntary, we recommend that BPS organizations should try to comply with the Interim Measures where they can in order to demonstrate that they are good “BPS citizens”.  Remember that BPS organizations still have to comply with the BPS Procurement Directive.

If you are unsure about whether your organization has to comply with the Interim Measures, feel free to reach out to DDO’s procurement team:

Kathy O’Brien – kobrien@ddohealthlaw.com

Michael Gleeson – mgleeson@ddohealthlaw.com

Pamela Seto – pseto@ddohealthlaw.com

 

DDO Health Law Update

April 5, 2019: A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.

Bills

 

Bill 74 is before the Standing Committee on Social Policy.

 

Regulations

 

No new and approved regulations of interest.

 

DDO

Sign up for Privacy Officer Training! Early Bird Deadline – April 12, 2019

Bill 74 – What does it really mean?

 

MOHLTC Newsroom

Province consulting with parents on enhancements to the Ontario Autism Program

Ontario taking next step in building a Connected Public Health Care System for Patients

 

Articles of Interest

 

MAID

The process of medically assisted death

Body donation to science after assisted death raises ethical issues

 

Cannabis

Pot stores are now legal in Ontario – get ready for lineups, shortages and delayed openings

‘It was totally worth the wait.’ Some customers lined up 24 hours to be the first to buy legal pot in Toronto

 

Health Care System

‘Please take textured breast implants off the market.’ Cancer survivors among Canadians urging FDA hearing to ban devices

Ontario’s vaccination coverage is not what you think. Here are the rates from Toronto to Ottawa that have experts worried

Can you still get sick if you’re vaccinated?

BC Company can sell prescription eyewear online in Ontario court rules

Front line health workers rally for stricter gun laws

Exclusive: Changes proposed to OHIP coverage

 

Autism

Ford government launches consultations on Ontario’s autism program

New Ontario autism funding program begins today

 

Professional Misconduct

Nova Scotia: Truro doctor to face hearing for professional misconduct, incompetence

Woodstock nurse punished for scheduling suspended colleague

 

Things to do this Weekend

https://torontolife.com/culture/movies-and-tv/every-new-title-coming-netflix-canada-april/

DDO Health Law Update

March 29, 2019: A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.

Bills

 

Bill 74 has been ordered to the Standing Committee on Social Policy.

 

Regulations

 

No new and approved regulations of interest.

 

MOHLTC Newsroom

 

Ontario focusing OHIP+ Benefits on those who need them the most

 

Articles of Interest

 

MAID

Woman sues Toronto doctors for allegedly ignoring father’s wishes to stay alive

 

Cannabis

‘We are hitting the deadlines’: Ontario cannabis lottery winner says Toronto ‘flagship’ on track to open April 1

Ontario cannabis stores expected to each take in $1.25M a month

 

Health Care System

From the hospital to the shelter and back again: Homeless B.C. seniors caught in heartbreaking shuffle

Arbitrator sides with Ontario parent who refuses to immunize children, cites anti-vaccination ‘expert’

Who are the anti-vaxxers? Here’s what we know- and how they got there in the first place

‘Seen as part of the job’: Ontario nurses, PSWs report ‘pervasive’ abuse in long-term care facilities

 

Autism

Ontario to spend at least $500M annually on autism, Lisa MacLeod says

‘Strong’ needs-based autism system on the way, Ontario Community and Social Services Minister says

Ontario enhancing support for children with autism

 

Mental Health

Federal government ordered to pay $20M for placing mentally ill inmates in solitary confinement

 

Privacy

Patient data exposed at 2 Toronto hospitals, privacy commissioner investigating

 

Professional Misconduct

Massage therapist convicted of sex assault has left Canada on eve of sentencing, lawyer tells court

 

Things to do this Weekend

Things to do this weekend in Toronto

DDO Health Law Update

March 22, 2019: A weekly scan of new legislation and regulations important to the Ontario health sector, as well as articles of interest.

Bills

 

Bill 74 has been ordered to the Standing Committee on Social Policy.

 

Regulations

 

No new and approved regulations of interest.

 

Articles of Interest

 

Cannabis

Toronto cannabis retail stores struggle to open by April 1 deadline

 

Wettlaufer

Wettlaufer inquiry won’t be expanded, judge rules

 

Health Care System

Ontario Health Minister announces 1157 new long term care beds

Shot in the dark: On vaccinations for measles and other diseases, data gaps leave Canadians guessing