The HAPS/HAA process is aimed at helping hospitals identify efficiencies to strengthen their operations and achieve a balanced operating position. It is based on the achievement of performance targets, as well as on negotiation and collaboration to the greatest extent possible.

Beyond volume of service, the performance targets for 2007/08 include the following :

• Total margin
• Current ratio
• Rate of readmission to the same hospital for selected Case Mix Groups
• Percentage of full-time nurses
• Percentage of chronic care patients with new stage two or greater skin ulcers

The signing of accountability agreements for 2007/08 represents the culmination of a six-month-long effort on the part of Ontario's 152 public hospitals that began in the summer with the Hospital Annual Planning Submissions (HAPS).

In September 2006, hospitals submitted their Hospital Annual Planning Submissions (HAPS) for 2007/08, detailing how they will meet performance targets under the Hospital Accountability Agreement (HAA). In November 2006, the ministry completed its review of the plans. This review included a comprehensive assessment of hospital operations, as well as the analysis and validation of all financial and supplemental data submitted by hospitals through the ministry's Web Enabled Reporting System (WERS).

Throughout December and January, five ministry regional teams, which included Local Health Integration Network (LHIN) representatives, met with hospitals to agree on appropriate service volumes, performance targets and opportunities to improve efficiencies.

As of December 13, over one third of hospitals had indicated that they were ready to go to their boards with their agreements.

This early success spoke volumes about the significant progress that Ontario hospitals have made in improving their performance, both financially and from an operational efficiency perspective.

The 2007/08 HAPS/HAA local negotiation process was completed on target in January with a large number of hospitals either with signed HAAs or in a position to sign their agreements. As of January 25, more than half of hospitals had either signed their HAA or indicated that they were ready to go to their boards with their agreements.

With local negotiations at a close, two hospital sector executives were enlisted for the next stage of discussions, Kevin Empey, Executive Vice President, University Health Network, and Wolf Klassen, Vice President, Program Support, Toronto East General Hospital.

As of March 29, the vast majority of hospitals had completed their agreements in time for the ministry’s April 1st transition of accountability and service agreements to LHINs. Remaining agreements are in the process of being finalized. As these are completed, hospitals can expect to receive notification from the ministry of the assignment of their agreement to LHINs.

According to the proposed timetable in the draft regulation for public consultation developed by the ministry, LHINs would begin to negotiate agreements for 2008/09 with the hospital sector in fiscal year 2007/08. LHINs have been involved every step of the way in this year’s negotiations.

For more information, read :

• Transitioning to LHINs : Implications for hospitals
• Update from the ADM of Acute Services [PDF]
• Issue 5 of Accountability Agreement Update [PDF]
• January 31^st Message from the ADM of Acute Services

Visit this section often for updates and, for more information about the HAPS/HAA negotiation process, read the HAPS Completion Guide.

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