Tag Archives: CE LHIN

Unintended Consequences – Northumberland Hills CEO says replacing ALC patients comes at a cost

Reducing the number of “alternative level of care” (ALC) patients in a hospital may have unintended consequences.

Robert Biron, CEO of the Cobourg’s Northumberland Hills Hospital, told the Central East LHIN yesterday that his current operating deficit may be partially linked to the hospital’s success in reducing the number of ALC patients from a high of 36.8 per cent in December 2010 to a low of 2 per cent in June of this year.

Alternate level of care patients are those who have completed their acute care treatment at the hospital but are not well enough to return home. Wait lists for long-term care beds and home care services have left many hospitals without an ability to responsibly discharge these patients.

Biron says filling the former ALC beds with high acuity patients requires more resources, not less, including advanced nursing care. These are additional costs to the hospital in a year when base budgets are frozen.

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Some LHIN boards finally open door to hear directly from public

From the beginning Local Health Integration Network board meetings have only allowed the public to witness the proceedings, never to participate.

Given the LHIN mandate to engage the public, the opportunity to be seen but not heard appeared absurd. Many a contentious meeting took place where community members were acknowledged in the room, but never allowed to express their concerns directly before the board.

Now several of the LHINs are establishing opportunities for the public to make deputations at the monthly LHIN board meetings.

The Central East LHIN has set extensive guidelines for individuals or groups to make deputations up to 15 minutes in length. The CE LHIN will set aside up to 30 minutes – or enough time for two deputations per meeting. The individual or group has to make an application to speak 30 days before the next board meeting, and the application must be clear about the proposed content and “align with the CE LHIN’s strategic aims.”

The application will be vetted and the Corporate Governance Coordinator will notify the interested party if they have been approved or not. Materials presented to the board must be similarly vetted.

Given an agenda for the LHIN board is seldom posted more than a few days before these meetings, the applicant will not necessarily know if they are speaking to a matter for a decision before the LHIN.

This appears to be a very cumbersome process, and will likely discourage many community organizations from participating. Many of the issues that come before the LHIN are seldom known in the community 30 days in advance.

By comparison, the Erie-St. Clair LHIN presents an open mic at its board meetings.  Open mic presenters have only need of registering in person on the day of the board meeting. They are limited to five minutes for their presentation, followed by another five minutes for questions and answers. There is no prescreening.

Erie St. Clair also makes opportunities for the community to present before open education sessions of the board.

At least these two LHINs are making an effort to open up. The Wellington-Waterloo LHIN makes no such opportunities available, insisting the public put their concerns in writing.

Most continue to maintain they are interested in hearing from the public, but just not at their board meetings where real decisions are made.

The province is presently rolling out new guidelines for public engagement, but there is no mandate to open up board meetings to community participation.

If the LHINs expect us to take community engagement seriously, they should do more to connect the community to their decision-making boards. Erie St. Clair and the Central East LHIN are at least making a start.