LHINs Legislation: Mental Health and Addictions Sector Perspective

1. LHINs Legislation:Mental Health and Addictions Sector Perspective Kate Dewhirst, Legal Counsel Centre for Addiction and Mental Health January 13, 2006

2. Overview • 3 Key Aspects of the Legislation • What are the practical changes HSPs will experience? • What is still unclear? • How can we influence the transformation of the system?

3. 3 Key Aspects of the Legislation • Plans • Funding • Integration

4. PLANS • MoHLTC – provincial strategic plan • publicly available • vision, priorities, strategic directions • LHINs – integrated health service plans • publicly available • vision, priorities and strategic directions for system and strategies to integrate • consistent with provincial plan and funding • ongoing community engagement (regulations) • HSPs – plans and priority setting for delivery of health services • community engagement (regulations)

5. FUNDING • MoHLTC to fund LHINs • multi-year accountability agreements • LHINs to fund HSPs for services the HSP provides in or for the geographic area of the LHIN • service accountability agreements with ALL HSPs (not just hospitals as in past few years)

6. INTEGRATION • HSPs obliged to look for opportunities to integrate • LHINs may integrate by: • Providing or changing funding to HSPs • Facilitating or negotiating integration • Issuing an integration decision (to integrate or not integrate) • LHINs make “integration decisions” • MoHLTC makes “integration orders” • LGC makes “integration regulations”

7. What are the practical changes HSPs will experience? • HSPs will need to develop a new relationship with their LHIN (and maybe more than one LHIN) • Ministry will not be the primary point of contact for planning and funding issues • How HSPs involve their communities when developing plans and priority setting for service delivery may be affected by rules set out in regulations

8. What are the practical changes HSPs will experience? • HSPs’ operating funding will come from a LHIN • HSPs will enter into service accountability agreements with LHINs – and there are penalties for non-compliance

9. What is still unclear? • What is the timing for the implementation of the legislation? • What will happen if an organization provides services in the geographic regions of more than one LHIN? (will the LHINs collaborate?) • Will there be protected funding envelopes for certain kinds of services? • How will provincial programs and services be planned and funded? • What is the expected role of provincial organizations in the transformed system?

10. What is still unclear? • What would happen if a LHIN decided to drastically cut funding to mental health and addictions services • Will the affected organizations (and broader sector) know before the decision is made? • Will we have opportunities to influence the decision?

11. How can we influence the transformation of the system? • Get to know the LHIN boards • Attend meetings of the LHINs boards (they must hold at least 4 meetings/yr) • As part of advocacy efforts for appropriate access to and funding for mental health and addictions services • review and comment on the provincial strategic plan • participate in community engagement efforts for priority setting at the LHIN level and their IHSPs • Proactively identify opportunities to integrate

12. LHINs Legislation:Mental Health and Addictions Sector Perspective Kate Dewhirst Centre for Addition and Mental Health Legal Counsel Phone: 416-535-8501 x 2128 Email: kate_dewhirst@camh.net