Ministry Reports

Final Report on the Transfer of District and Local Mental Health & Addictions Program in Northeastern Ontario

Submitted By Ken W. White, President & CEO of Trillium Health Centre


Background

On November 2004, the Minister of Health and Long-Term Care appointed Mr. Ken White to be the Facilitator for the transfer of local and district mental health and addictions programs in Sudbury and North Bay.

Two Advisory Committees, one in North Bay and one in Sudbury, comprised of community leaders representing various health system perspectives were established to assist with this initiative.

The following outlines the summary of recommendations, which were included in the final report to the Minister of Health and Long Term Care :

Local and District Mental Health and Addiction Programs

  1. Hôpital régional de Sudbury Regional Hospital (HRSRH) has agreed to accept the following programs identified for transfer:
    • Sudbury Community Programs :
      • Assertive Community Treatment Team 1, Sudbury
      • Assertive Community Treatment Team 2, Sudbury
      • Case Management / Positive Steps
      • Psychogeriatric Outreach Programs
      • Concurrent Disorders, Sudbury
      • Community Treatment Orders, Sudbury
      • Pinegate Addictions, Treatment-Problem Gambling
      • Pinegate Addictions Withdrawal Management Programs
    • Sudbury Community Clinics :
      • Espanola Clinic
      • Manitoulin Clinic
      • Suicide Prevention, Espanola
      • New Directions, Hanmer Valley East
      • Walden Help Centre, Lively
      • East Algoma Clinic, Elliot Lake
  2. Transfer the Regional Program component of the Eating Disorders Program currently operated by to NEMHC.

    Complete implementation plan by June 30, 2005, and implement by October 1, 2005.

    North Bay General Hospital (NBGH) has agreed to accept the following programs identified for transfer :

    • North Bay Community Programs:
      • Assertive Community Treatment Team 1, North Bay
      • Assertive Community Treatment Team 2, North Bay
      • Rehabilitation Resources
      • Dr. Claude Ranger Clinic
      • Concurrent Disorders, North Bay
      • Community Treatment Orders Coordination, North Bay

Recommended Funding Investments

As part of the consensus building process, issues of pressures on various transferring programs came to light. Both one-time and base funding needs have been identified in the report, estimated at approximately $1.6M. The following recommendations regarding financial pressures must be addressed to ensure a smooth and efficient transfer of he identified programs :

In Sudbury ($1,390,000):

  • Annualized funding is to HRSRH to support the $330,000 program deficit in Community Mental Health Programs as identified on page one
  • New annualized funding of $200,000 to NISA to stabilize this consumer/survivor program
  • New annualized funding of $200,000 for clinical positions to begin the process of developing a robust mental health outpatient clinic program in Sudbury
  • New annualized funding of $200,000 to allow for consolidated community programs, enhancing service delivery
  • New annualized funding is provided to HRSRH to support wage harmonization, estimated to be $160,000
  • One-time training and orientation costs for staff transferring from NEMHC to HRSRH in the amount of $200,000 (80 FTE's)
  • HRSRH's one-time legal and IT costs associated with the transfer, estimated to be at least $100,000

In North Bay ($217,500):

  • Annualized funding for 1 FTE clinical position in the community mental health program annualized at approximately $100,000
  • One-time funding for training and orientation costs estimated to be $117,500 for staff transferring from the NEMHC to the NBGH

Acute/Long-Term Psychiatric Specialty Beds

While not part of the original mandate it became clear, early on, that the issues requiring resolution surrounding both the acute care and specialized care beds were closely related to the transfer of the community programs. Therefore, the findings and recommended solution for the beds proposed and agreed upon by all parties was included as an appendix in the final report submitted to the Minister in August 2005.

The revised bed distribution plan will no longer necessitate the movement of programs between North Bay and Sudbury. The revised bed planning targets take into account current expertise in Sudbury and North Bay. The recommendations pertaining to acute/long-term psychiatric specialty beds are as follows :

  • MOHLTC announce long-term psychiatric services will be concentrated in North Bay to allow the NEMHC to focus on best practice models of care in a consolidated environment;
  • Announce an increased number of short-stay acute care mental health beds to be governed and operated by the HRSRH from the current proposed 39 to 60;
  • Confirm that over time, within the 60 beds in Sudbury, 12 beds will become specialized longer-term regional service beds;
  • That these 12 specialized beds be operated by HRSRH and that the HRSRH be accountable to NEMHC for ensuring their use is consistent with the intent described;
  • That the resources related to the 31 tertiary beds proposed for Sudbury, but now remaining in North Bay, will be retained by NEMHC;
  • That the NEMHC and HRSRH should complete their implementation plan for the bed transfer by October 30, 2005 and should execute that plan as soon as possible, but no later than December 31, 2005 (these timelines may require adjustment).

Additional Recommendations

The three parties in North Bay, comprised of NBPH, NBGH and NEMHC, are encouraged to begin discussions to ensure a smooth transfer of community programs.

To ensure sustainability of the system, it is recommended that a Mental Health/Addictions Advisory Council be established with representatives from the NEMHC, Adult Mental Health and Addictions District Planning Groups, Northeast Ontario Consumer/Survivor Network (NEON), and appropriate Aboriginal cultures. This council's primary mandate would be to advise on mental health design and enhancements, and would be directly accountable to the Northeast Local Health Integration Network (LHIN).

Conclusion

The implementation of the recommendations included in the report will equire the continued dedication and involvement of the affected parties, including the Ministry of Health and Long-Term Care. I would like to thank the Community Advisory Committees members, the Operations Committee members and ministry staff for their dedication and commitment to this process.

Ken W. White, Facilitator

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