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Seniors would be priority for Southlake-led Ontario Health Team

'The big benefit is that we're going to be rewriting the rules of engagement,' official says of new health team structure

Seniors with complex medical needs, the frail elderly and people requiring mental health and addiction care would be the year-one priority if Southlake Regional Health Centre and its local partners are tapped to be one of Ontario’s first integrated health teams.

The Newmarket hospital and its 11 partners, including Community & Home Assistance to Seniors (CHATS), are one of 31 self-styled groups of health-care providers that last week received the green light from the provincial Health Ministry to submit a full proposal to deliver a new model of health care under what’s known as an Ontario Health Team.

“We chose those populations because what we see in our catchment area is that those (groups) are putting the most pressure on the health-care system right now and that’s where we have the most gaps,” Southlake president and CEO Arden Krystal said this week at a news conference at CHATS’ Aurora facility.

“We think we can quickly make some improvements in those areas.”

The creation of an as yet unknown number of new regional health teams will replace the 14 regional, local health integration networks that are responsible for planning and funding local, integrated health care within their geographic boundaries.

Now, it’s expected that the Ontario health teams will assume those responsibilities, with each team receiving one lump sum of funding to divvy up among themselves to deliver such services as primary and acute care, and home and community care, as one coordinated team. Individual funding to the partners will be eliminated.

It is part of a major overhaul of Ontario’s current health-care system that has so far included folding 20 government health agencies into one body known as Ontario Health, and reducing the province’s 35 public health units into 10 regional agencies by 2020-2021. 

If successful, the Southlake Community Ontario Health Team, as it’s being called, will serve a geographical area estimated to be about 330,000 people, and will include the communities of Newmarket, Aurora, Bradford West Gwillimbury, East Gwillimbury, the northern part of Richmond Hill, and a portion of Whitchurch-Stouffville.

“We believe that the Ontario Health Team that we’re creating here is going to result in better transitions for patients, much more seamless care, patients being able to get home sooner than they can get home right now, because of having more robust community services to support them in their own homes, and more opportunities for respite care for caregivers,” Krystal said. “And what that’s going to result in, in our hospital is, we believe, less hallway medicine, less patients in unconventional spaces, in our hallways, and in our emergency department.”

The term “hallway medicine” was bantered about last spring by a then-campaigning Doug Ford, who promised to end the overcrowding that has plagued local hospitals for years, if elected.

Premier Ford recently boasted that his Conservative government will, within the next year, get the “1,000” patients that remain in hallways in Ontario’s hospitals out of there.

However, in a recent interview with NewmarketToday, Health Minister Christine Elliott said such major system change is “not something that is going to happen overnight”.

CHATS CEO Christina Bisanz said the agency that works to support older adults to live independently, safely and with dignity in their own homes for as long as possible has a long established history of working with Southlake as a partner.

“But this new model is now bringing more providers together and ensuring we’re working as best as we can,” she said.

Southlake’s other proposed partners include the Canadian Mental Health Association York Region and South Simcoe, Extendicare, Georgina Nurse Practitioner-led Clinic, LOFT Community Services, the Regional Municipality of York - Paramedic and Seniors Services, and more.

An estimated five-year ramp-up period could see more community health providers added to the local health team.  

“Instead of each of us operating in silos and not necessarily knowing what the other is offering, or how we could work together to improve the outcomes, and recognizing that there is a value to social care as well as health care, is the biggest change up to this point,” Bisanz told NewmarketToday. “We often don’t communicate with one another, and clients and their caregivers are left to navigate this very complex system on their own.”

While there’s still a lot of unknowns and uncertainty about the new health teams, Bisanz said she feels strongly that the services CHATS provides are only going to increase in terms of demand and need.

“We play a vital role and we have a lot of value to bring,” she said. “Much of what we do is a much more efficient way of supporting people to stay at home and support caregivers not be overburdened and stressed.

"We provide adult day programs, meals-on-wheels, assisted living, and transportation. It’s a much more efficient and effective way of using those health-care dollars. We’re encouraged that community agencies are finally being recognized that we are full partners in the delivery of health and social care and we can work better together than in our silos.”

For Dr. David Makary, a family doctor who heads Southlake’s academic family health team, less wait times and easier access to primary care and other health-care providers may well be one of the benefits of such a new system.

“In the early planning stages, it is easy to see how this is really going to enable primary care to help patients along their journey,” he said.  

In addition, the hope is that with better connected and coordinated care, patients who don’t have a family doctor will be assigned one.

“We certainly want to see every patient in our community with a primary care provider,” Dr. Makary said.

As for what is on the horizon for local health care, Krystal said she and her partners “envision a new future where we’ll be able to wrap services around (clients) so the patient can stay in their home much longer and caregivers can be supported”.

“To be frank, in Ontario’s verve to be accountable with tax dollars, which is a really good thing, there’s been a bit of an obsession with process and counting. Counting the amount of service that people get as opposed to looking at the outcome for those people,” Krystal said.

“What the Ontario Health Team will shift to is less about counting exactly how many hours of care someone got, and more about did it keep her out of hospital in the first place. If we can shift to that, we can be accountable, and focus on the right things rather than the process," Krystal added.

Bisanz agreed, and said the potential to drive more efficiencies in the health and social-care system, ensuring that clients and family caregivers are supported in a way that uses health-care dollars and resources in the most efficient way while producing better outcomes for the clients themselves is a welcome move.

“The big benefit is that we’re going to be rewriting the rules of engagement,” Bisanz said. “Rather than having to wait for the local health integration network to decide that they will do the referral or allow a joint partnership to exist, the new model enables us to look holistically at what the patient needs, who’s got the service, how can we integrate it in the best way, and not have these artificial regulatory barriers standing in our way that have contributed to the health-care silos that currently exist.”

The Southlake Community Ontario Health Team will submit its final proposal to the health minister Oct. 9, 2019. Decisions on who will form these new teams to deliver local health care is expected in early 2020.