Alternate Level of Care (ALC) in Sudbury and the North East LHIN

1. Health and wellness for all. Santé et mieux-être pour tous. Wii-mino- bimaadiziiyang kino Alternate Level of Care (ALC) in Sudburyand the North East LHIN

2. A Four Letter Problem … F L O W …more ALC admissions than discharges …

3. Getting to this point… • The North East LHIN has the highest rate of ALC patients of any LHIN across the province. • According to weekly reports submitted by Sudbury Regional to NE LHIN, Sudbury Regional had about 90 ALC patients in April 2008, number rose to 110-115 mid-summer and sat at approximately 100 in September. • During the month of October, Sudbury Regional had approximately 125 ALC patients and began cancelling approximately 10-20 surgeries per week due to the high ratio of ALC patients in acute care beds.

4. Cursory Review of NE LHIN Sudbury ALC Actions to Date • During 2007/08 and 2008/09, applied close to $10 million for ALC across the North East. • Applying three-year $19 million Aging at Home Strategy. • $1.2 million towards Regional Geriatric Program. • Continued funding for 20 transitional care beds ($645,000/year). • $555,000 for ALC Wrap Around Program ($288,000 for Sudbury Regional).

5. Solution: Building system capacity through… • Beds and Housing Options • 24 interim transitional beds (November 20, 2008) • 128 long-term care beds – Chelmsford, 2011 • St. Joseph’s Health Centre will open 64 beds on April 1 2009, of which: • 32 are Complex Continuing Care • 32 will be used for ALC pressures in the short-term (of which 12 represent additional capacity) • NE LHIN Seniors Residential Housing/Options project – results to LHIN Board on November 28

6. Solution: Building system capacity through… • ALC Wrap Around Services • Helping to reduce the ratio of ALC patients in the hospital by increasing patient’s access to home and community supports. • Helping to discharge existing ALC patients more quickly and/or prevent a hospital admission by a potential ALC patient. • Examples of wrap around services include: home supports such as meal preparation, housekeeping, snow shoveling, equipment/aids, etc.

7. Solution : Building system capacity through… • Care Pathways • Agreement from NE LHIN, NE CCAC and Sudbury hospital administration to immediately work together to determine profiles of ALC clients, clustering profiles into client groups, and building programs around each client group. • Commitment to build the program at Sudbury Regional, move to adopt it in remaining three large NE hospitals, spread success to smaller hospitals across the region.

8. Solution : Building system capacity through… • Nurse Outreach Team • Awaiting confirmation from Ministry of Health and Long-Term Care (by December 1) on allocation of Nurse Outreach Team in Sudbury to address patients coming into Emergency Department from Long-Term Care homes.

9. Solution : Building system capacity through… • Aging at Home • Working with Ministry of Health and Long-Term Care to determine the correct allocation of provincial Aging at Home funding to ensure it accurately reflects the ALC pressures in the North East. • Of the 26 funded programs out of the Strategy’s Year 1 funding ($4.2 million), $1.2 million went to programs in the Manitoulin-Sudbury planning area.

10. In Conclusion, the NE LHIN: • Wants what is best for patients. • Agrees that situation cannot continue as is. • Understands that high rates of ALC patients in acute care beds impacts patients, physicians and administrators. • Strongly believes that one solution or group WILL NOT solve ALC – it has to be a collaborative effort and a range of solutions. • Will work with partners on long-term solutions; short-term band-aid solutions will not stop the flow over a long period of time.

11. Health and wellness for all. Santé et mieux-être pour tous. Wii-mino- bimaadiziiyang kino Thank you Merci Meegwetch