Category Archives: Local Health Integration Networks

The 14 Local Health Integration Networks (LHINs) are grappling with a common framework for community engagement.

The issue came to the Central East LHIN January 26^th where board members wrestled with the idea of community empowerment versus the LHIN’s own legislative responsibilities.

James Meloche, a Senior Director with the LHIN, raised as a positive example the citizen’s jury model used by Northumberland Hills Hospital during its reorganization last year. Northumberland Hills used a random selection of local citizens to give advice on changes to the hospital.

Many in the community felt that the group had been manipulated by the hospital and that they hadn’t represented the significant dissent in the community towards cuts proposed by the hospital.

Meloche said that while the LHINs were instructed to come up with a common framework, there would still be flexibility for the individual LHINs to determine their own processes. “The paint will never be dry on how you operationalize this,” he said.

Board member Stephen Kylie said the idea of a Citizen’s Jury bothered him, that it may be viewed by the community as elitist.

Foster Loucks, Chair of the Central East LHIN, said he was concerned about the absence of reference to government relations or the involvement of labour, including union and non-union employees. Loucks said the framework appeared too focussed on health care providers and stakeholders.

Loucks also said it was important to communicate how the information shared in these consulations would be used in the decision-making process.

Meloche said the drafters of the framework “didn’t have a heavy dose of realism.”

He also spoke of the need of health care providers to do their own consultation. “We cannot be the only community engagers in the system,” he said.

The LHIN postponed any endorsement of the draft framework to their next meeting in February.

Kathy Durst, the Chair of the Waterloo Wellington Local Health Integration Network (LHIN) is quickly learning about accountability – but perhaps not in the way she imagined.

The LHIN had paid $16,000 of the $20,000 tuition for two courses Durst took at McMaster University on accountability and social responsibility. In addition, Durst claimed $350 a day per diem while attending the courses.

It was reported in the Cambridge Times that Durst claimed $81,900 in per diems last year for a position the LHIN describes as part-time.

Durst says she is sharing her new-found knowledge with her colleagues at the LHIN.

Does she mean her courses, or what it means to have the health minister grilled over your perks by the opposition Tories?

Both the Tories and the NDP have had the LHINs in their sites recently in the Ontario legislature. While the government maintains it is shifting services out of hospitals and into the community, the reality is that the services are just not there.

Frank Klee (MPP Newmarket Aurora) raised the story of a 28-year-old with muscular dystrophy seeking complex continuing care.

“He’s in a wheelchair and has serious respiratory, heart, bowel and urinary problems, and requires continueous, mechanical ventilator support 24 hours a day,” Klee said. “His parents, now both over the age of 60, can no longer provide the complex continuous care that he needs.”

Klee said the Community Care Access Centre told the family they were unable to help, and referred them to the Central LHIN. The Central LHIN in turn told the family to go back to the CCAC.

Howard Hampton (MPP Kenora – Rainy River) said half the medical surgical beds in Kenora’s Lake of the Woods District Hospital are occupied by 27 “alternate level of care” patients who have been waiting for 130 days for a long-term-care bed.

Hampton said supportive housing “proposal after proposal after proposal” have been taken to the North West LHIN without “much of a response.”

Stories of long term care bed shortages are increasing after the McGuinty government decided to hold the line on new beds.

Health Minister Deb Matthews acknowledged her government still had a lot of work ahead to improve care, and said the LHINs are very focused on the issues the opposition members raised.

This is the first year for agencies to sign accountability agreements with the Local Health Integration Networks. Many small agencies are quickly discovering the paperwork and data collection associated with these agreements is overwhelming their ability to provide front-line care.

Steve Clark (MPP Leeds-Grenville) raised the issue in the legislature last week. He said Heather Brough, program coordinator of Hospice North Hastings, had told him that she spends 80 per cent of her time on LHIN paperwork and meetings, taking her away from helping people.

“She’s fed up with the LHINs and is willing to forgo the $52,000 a year the hospice gets from them,” Clark said.

Minister of Health Deb Matthews said she was unfamiliar with the case, but would take a look at it. She said she knows they need to do a better job of building a continuum of care in our health care system.

Board members at the SW LHIN asked Wednesday about a budget line which indicated an increase in LHIN salaries this year. Wasn’t there supposed to be a freeze for non-union staff? The LHIN replied that these were “performance increases” earned in 2009/10 and paid in 2010/11. For performance increases, salaries over $150,000 were limited to 1.5 per cent. There was no indication of how much of a “performance” increase was paid out for those under $150,000 per year, however, the total salary line was increasing by $464,315, or 15.31 per cent more than the previous year. While salary increases were a part of this, the LHIN also argues they are carrying the increased cost of vacant positions which have since been filled. The SW LHIN has 36 full-time equivalent positions.

The budget also gave some idea of how much the LHINs were spending on outside consultants. In 2009/10 the SW LHIN spent $634,381 on outside consultants. In lean times, they are expecting that budget line to drop to $145,730 in the coming year, a whopping 77 per cent drop. This matches what is happening at the Ministry of Health. The overall LHIN operating budget will actually drop by half a percentage to $6,008,850. This does not include allocations to health care providers. Taken together, the SW LHIN operates on .29 per cent of the region’s health services budget.

Is it better to have health care services closer to home, or consolidated in a single location? The SW LHIN apparently likes it both ways. A proposal to consolidate breast cancer services was heralded as increasing efficiency, while a proposal to divest mental health beds to Kitchener was lauded as placing patients closer to home. Board member Dr. Murray Bryant did point out that the breast cancer consolidation would likely result in some of London’s low income women having to take up to four buses to access the program. That would be further from home. He also pointed out that the wait times target set by St. Joseph’s Health Care for the breast cancer program was way too modest.

With all the bad news coming from the Ombudsman’s report and embarrassing series of stories emerging from the Erie St. Clair LHIN, it was no surprise that improving the image of the LHIN was a topic of the Chair’s report. SW LHIN Chair John Van Bastelaar said the LHIN staff were reluctant to call it “marketing.” No matter what it’s called, the SW LHIN has increased its communications/forums budget by 9.69 per cent for this year.