Haliburton County Health Services

Integration Strategy



Integration Strategy - Opening Doors and Conversations


pdf Ontario is Launching Pilot Project for Rural Health Hubs (270 KB)


pdf Announcement from the Office of the Premier - August 7, 2016 (270 KB)  


Haliburton Highlands Health Services

Update on Integration Journey

May 2015

pdf Download the pdf version

Phase 1:  CE LHIN Community Health Services Integration Strategy (2012)

It was determined that the optimal result of integrating health services would involve a "Cluster-based service delivery model" through integration of front-line services, back office functions, leadership and/or governance to:

  • improve client access to high-quality services
  • create readiness for future health system transformation
  • make the best use of the public's investment

Hospitals were included in the Northumberland County and Haliburton County/City of Kawartha Lakes  planning processes.  The first Phase included:

  • Community Care City of Kawartha Lakes
  • SIRCH Community Services
  • Community Care Haliburton County
  • Victorian Order of Nurses, Ontario Branch
  • Ross Memorial Hospital
  • Haliburton Highlands Health Services

Integration Planning – Haliburton County /Kawartha Lakes

January 2013:  Integration Planning Team (IPT) formed to include Executive Directors of CE LHIN-funded health services organizations in Haliburton County and City of Kawartha Lakes
  • Mandate to develop an integration plan
January – May 2013:   Weekly meetings of IPT
  • Commissioned literature review of rural health models
  • Determined decision-making criteria to evaluate models
  • Evaluated models from status quo to single organization across the two communities
  • Recommended model to include two health services providers in Kawartha Lakes and “one entity” in Haliburton County
June – July 2013:  Community consultations with other health services agencies (EMS, CMHA, Ontario Shores, CCAC, FHTs) and general public/clients
September 2013:  Finalized draft Integration Plan
October – November 2013:  All Boards approve Integration Plan
December 2013:  Haliburton County / Kawartha Lakes Health Services Integration Plan was presented and approved by the CE LHIN Board


Phase 1:  Integration Recommendations for Haliburton County:

  • Voluntary merger between Community Care Haliburton County and Haliburton Highlands Health Services
  • “One Entity” to deliver hospice/palliative services provided by SIRCH and Adult Day Program services provided by VON.
  • Accountability for coordinating Foot Care services would also be transferred from VON to the “One Entity”.
  • SIRCH and VON would continue to exist as ongoing agencies, with their own boards, programs and services, but would no longer have an Accountability Agreement with the CE LHIN
  • Volunteer Co-ordination – SIRCH would investigate piloting a new model (Volunteer Match) that could be used by the “One Entity” in Haliburton County to recruit, screen, orient and train volunteers


Phase 1: Strategic Alliance between Ross Memorial Hospital and Haliburton Highlands Health Services

Established to facilitate existing and future shared services opportunities, including:
  • Laboratory Services
  • Medical Device Reprocessing
  • Medical Records Transcription
  • Shared Information Technology Department
  • Inventory Management System and Procurement
  • Pharmacy Services
  • Mental Health Leadership
  • Cardiac Rehabilitation
  • Diagnostic Imaging Management
  • Document Management System for Policies and Procedures


Phase 1:  Benefits of “One Entity” in Haliburton County

  • Local autonomy and local management over Haliburton County health services
  • Potential cost savings for reinvestment
  • Local residents would not have to go through as many “doors” and would have access to a broad range of services
  • Improved continuum of care
  • Streamlined volunteer opportunities for local residents who want to support their local health care organization
  • More opportunities for staff in a larger organization
  • “One voice” with an understanding of the health needs of the residents of Haliburton County to advocate for/apply for new funding


Phase 2: Transition Planning for Haliburton County

January 2014:  Discussions began between Community Care Haliburton County and HHHS related to their amalgamation and more specifically about the governance structure for the amalgamated organization with decision to have HHHS be the “one entity organization
February 2014:  Transition Team, with executive representation from HHHS, CCHC, SIRCH and VON, was formed to begin planning for the implementation of the Integration Plan in Haliburton County (weekly meetings)
Integration transition project plan developed by Transition Team to address:
  • Governance
  • Communication
  • Human Resources
  • Volunteers
  • Clients
  • Finances/Budget and Fundraising
  • Facilities
April 2014:  Directional Plan approved by all Boards
May 2014: Transition Plan  complete  with October 1, 2014 set and approved as Transition Date
June 2014:  Central East LHIN Board approved Transition Plan
July – September 2014:  Continued focus on project tasks leading to Transition Date
October 1, 2014:  Staff, volunteers, clients, programs, funding and accountability agreements  transferred to HHHS



Phase 2:   Governance Plan

Although the Integration Plan called for the formation of a new Health Services Entity for Haliburton County, discussions were initiated with Community Care and HHHS since the governance of only these organizations were to be impacted
The two Boards agreed that the new “One Entity” would be HHHS and Community Care Haliburton County would wind-down as a corporation following the transfer of the community services on October 1, 2014
To facilitate implementation of the Governance Plan, vacancies on the HHHS Board were held for Community Care Board members who wanted to move to the HHHS Board and would do so as of the HHHS Annual General Meeting on June 26th, 2014
Recommended development of Community Advisory Committee to give a “Voice” to community support services providers and clients

Phase 2:  Governance Progress

June 2014:  HHHS Board (including nominated Directors from the Community Care Board)  held a Strategic Planning session, as part of the process to develop a new Plan, to determine HHHS priorities for 2014/17
August 2014:  Full-day Board orientation session held for all HHHS Board, including the new Directors from the Community Care Board, with an agenda to educate all about HHHS services and the new transferred services:
  • HHHS Governance – Model, Committee Structure, Policies
  • CE LHIN / Ministry of Health and Long-Term Care – Mandates, Priorities, Relationship to HHHS, Capital Process, Governing Legislation
  • Financial Management – Budgeting, Reporting, Financial Statements, Capital Budgets
  • Overview of Hospital Services – ED, Acute and Palliative Care, Physiotherapy, OTN
  • Overview of Long-Term Care Services – Hyland Crest, Highland Wood
  • Overview of Community Services – Supportive Housing, Diabetes Education, Community Support Services, Hospice, Adult Day Programs, Mental Health Services
  • HHHS Partners – Ross Memorial Hospital, Family Health Team, CCAC, EMS

Note: The afternoon of the Board Orientation day was a follow-up session for Strategic Planning to present the draft Strategic Plan

September 2014:  Strategic Plan 2014-2017 was approved

Phase 2:   Governance Progress

Strategic Plan 2014-2017

Phase 2:  Governance Lessons Learned

Local autonomy and local management over Haliburton County Health services (versus governance and management from Kawartha Lakes) was important for the all Haliburton County Boards, so it became a common rallying point
  • Development of a Strategic Alliance and operational integration initiatives between Ross Memorial Hospital and HHHS was supported by the HHHS Board because it did not impact on local autonomy
Recognition that HHHS was perceived as the large hospital with a medical culture that would swallow up the small community agencies in Haliburton County, so bent over backwards to be respectful of the differences of approach to governance and accommodating to the input of the smaller community agencies throughout integration
Bringing on members from the Community Care Board to the HHHS Board facilitated the transition of services
Full Board orientation was important to educate HHHS Board members about the community services being transferred  into the organization, as well as for the new members from Community Care about HHHS services
The creation of the Community Advisory Committee as a sub-committee of the Board was perceived favorably by community agencies and the public
Ongoing support to CEO and leadership team regarding integration


Phase 2: Integration Lessons Learned

Leadership:  critical to success; need positivity, commitment, persistence and focus on what is best for community from the Board(s) and executives
Project Management Resources:  should include dedicated  project management support, if possible, rather than adding stress to operational responsibilities of CEO and Management Team
Communication/Community Engagement:  should be done regularly and consistently (never enough) with all internal and external stakeholders who would be directly impacted as well as general public, using a detailed Communication Plan
Change Management: integration is not easy and one must not underestimate organizational anxiety and upheavals that may result, including staff/management departures; so need to have a comprehensive change management plan that includes significant communication, education
LHIN Direction and Support:  strong and ongoing support is needed from the LHIN to initiate and facilitate integration planning, including providing additional resources if required
Integration Has Benefits: alignment to LHIN / Provincial strategies yields organizational benefits; for example, Community Services Enhancements and funding

Phase 3:  Long Term / Future Planning

The  2014/2017 Strategic Plan highlights Health System Integration as one of five strategic directions for HHHS over the next several years to build on the community services integration
HHHS will strive to further develop as a comprehensive Rural Health Hub over the next several years to become the model for the Province
HHHS will leverage its integrated organizational structure and continue to improve quality and enhance the range of services to meet the needs of full-time and seasonal residents and visitors of Haliburton County
HHHS has set an objective to develop a Master Program and Master Plan for the next 5-10-15 year timeframe to meet the needs of a proportionately large and growing seniors population that has higher than average complex health issues
  • Master Program will define what programs and services will be required to meet the future health needs
  • Master Plan will determine what facilities, including alterations, additions and rationalization across sites, may be required to carry out the Master Program
Discussions have been initiated with the Board and local municipal leaders about Master Programming and Master Planning
The CE LHIN has been approached to support Phase 3 of our integration journey


pdf Printable pdf Version of the Presentation