Community Accountability Planning Submission (CAPS) Frequently Asked Questions (FAQ)

Transcription

1 Community Accountability Planning Submission (CAPS) Frequently Asked Questions (FAQ) October 10, 2013

2 Table of Contents INTRODUCTION... 4 GLOSSARY OF TERMS... 4 FREQUENTLY ASKED QUESTIONS AND ANSWERS General Is a CAPS required for each HSP? How do the CAPS and the M-SAA fit together? Why do the CAPS and M-SAA cover a three year period? Is it realistic to plan for three years when there are many changes underway within the Sector, including initiatives that are under development or are expected to be rolled out over the next couple of years? What do the LHINs do with the CAPS information? Who are the members of the M-SAA Advisory Committee? Education & Supporting Documents Within the CAPS Reference Overview (both English and French versions), the first graphic within Section 3 is not fully visible In the CAPS HSP Orientation presentation, the embedded audio does not play Planning How will LHIN-specific goals and objectives be integrated and reflected in the M-SAA and CAPS? Are we planning for no across-the-board increases for all 3 years? With a 0% increase over the next 3 years, do HSPs have the flexibility to redistribute dollars and/or activity within their existing budget? With a 0% increase over the next 3 years, is it alright for the planning targets for , and to be the same? With a 0% increase over the next 3 years, how do HSPs address pressures? How does an HSP record short-term funding from Other Funders (eg. United Way) when it is not known whether the funding will be received entirely within one fiscal year? Is it possible for an HSP to redistribute funding that was provided in the past for a particular Functional Centre? Should an HSP add new programs to the CAPS that were approved in ? Is there another form (service delivery change form) to fill out for changes to the services offered by an HSP? Can administrative costs be offset by recoveries made by a levy on other funding (eg. Trillium grant, midwifery TPA role)? How does an HSP record administrative costs if it is still ramping up operations? How can Physician vacancies be recognized in the CAPS? A prolonged vacancy might swing the proportion of budget spent on administration by 1% or so Where can we find information that would help us determine or compare unit costs across the LHIN and across the province? How do HSPs budget for projects in response to LHIN Request of Proposals (RFPs)? Reporting On the identification page of the CAPS form do we need to complete both the Recipient Number and Facility Number sections How will an HSP know if any definitions have changed within the OHRS since the last CAPS ( )? Do Administration Costs include meals provided to clients?

3 4.4 Can rent costs be included as Administration since OHRS identifies rent as a possible administration cost? Who is responsible for reporting the financial and statistical information when an HSP is funded by the LHIN to subcontract a service or program to another service provider? How should CHCs report their LHIN-funded programs when some Functional Centres listed within CAPS Parts A & B are not at the Functional Centre reporting level (level 5)? What should CHCs report within the Budget (Historical) column on the Activity Planning Page for Functional Centres that were not included in the previous CAPS? What is an example of Other Medical Staff on the Finance Screen listed under Medical Staff Remuneration? Will HSPs involved in Health Links be required to submit projections for service targets within the Functional Centre Provincial & Regional Health System Development? Does Hours of Service include both In-House and Contracted Out hours? How can an HSP modify the statistics that are reported for a Functional Centre if some of the rows listed on the Activity Planning Page do not apply to a particular service? How does an HSP report Service Provider Interactions if they are required for a Functional Centre? How does the OHRS account for differences in resource intensity within the reporting of Service Provider Interactions? What is the difference between A2-1 and A2-2 within Part A of the CAPS? Is the Description of Services A2-2 used for Fund Type 3 only? Submitting What is the deadline for the submission of the CAPS? Will the deadline be extended? Will there be some leeway for Municipalities that are unable to obtain Council approval of their CAPS by November 15 due to the pre-booked dates of their Council meetings? How will HSPs submit the CAPS forms? Does the CAPS need to be Board-approved? Why does the HSP not have the option to click No Change within the Description of Services and Population and Geography Narrative sections of Part A of the CAPS for Why is there variability between LHINs on the date that the CAPS has to be submitted? Why is there variability between LHINs on whether to plan targets for only one year or three years? Why is the Budget (Historical) column in the CAPS blank? How can an HSP correct information in the CAPS if it has been imported incorrectly from the CAPS file? When uploading the CAPS file to SRI, can an HSP change the name of their CAPS file? If a CAPS file is Checked In within SRI, but not submitted, can it be Checked Out again? Should an HSP report service activity related to its entire corporation or just the volumes that are associated with LHIN-funded programs? Indicators Will the LHIN be reconsidering the target set for the Proportion of Budget Spent on Administration indicator for ? Who is responsible for the creation of the provincial indicators? How will M-SAA indicator targets be determined? Will the LHINs provide definitions for indicators, performance targets and performance standards? When is there an opportunity to renegotiate Functional Centre targets or MSAA indicator targets?

4 Introduction This document contains answers to Frequently Asked Questions (FAQs) related to the Community Accountability Planning Submission (CAPS). As further questions are received from Health Service Providers and LHINs, the document will be expanded to include additional answers. Glossary of Terms CAPS refers to the Community Accountability Planning Submission HSP refers to a Health Service Provider as defined in LHSIA LHIN refers to a Local Health Integration Network LHSIA refers to the Local Health System Integration Act, 2006 MSAA refers to the Multi-Sector Service Accountability Agreement MOHLTC refers to the Ministry of Health and Long-Term Care OHRS refers to the Ontario Healthcare Reporting Standards Sector refers to the Community sector 4

5 Frequently Asked Questions and Answers 1. General 1.1 Is a CAPS required for each HSP? A: Yes, a CAPS is required by every Community Sector HSP that receives funding from a LHIN. 1.2 How do the CAPS and the M-SAA fit together? A: The CAPS, together with the M-SAA, form the basis of a multi-year planning framework. This framework supports the Province s efforts to enhance stability and accountability of the health system by facilitating alignment of the provision of health services to MOHLTC and LHIN priorities. 1.3 Why do the CAPS and M-SAA cover a three year period? A: A three-year term for the M-SAA allows greater consistency and stability by providing a longer period for planning and implementation. It allows LHINs and HSPs to better align reporting without revisiting requirements each year. It is understood that the information provided in the CAPS is current at time that the form is completed. If the information changes substantially during the term of the M-SAA, there may be an opportunity to refresh CAPS and issue an M-SAA amendment reflecting the changes. 1.4 Is it realistic to plan for three years when there are many changes underway within the Sector, including initiatives that are under development or are expected to be rolled out over the next couple of years? A: A multi-year plan ensures that both the HSPs and the LHINs consider the impact of care requirements for the population over time. The information will serve to inform system planning over the period in question and beyond. It is understood that these will be plans only, and it may be necessary to make adjustments based on funding announcements or policy changes. 1.5 What do the LHINs do with the CAPS information? A: The information submitted through the CAPS will guide discussions between a LHIN and an HSP to finalize a new M-SAA, which will come into effect on April 1, The Description of Services form in Part A of the CAPS will also contribute to the preparation of one of the Schedules in the M-SAA. It is understood that the information provided is current at the time that the form is completed. If the information changes substantially during the term of the M-SAA, an M-SAA amendment will be prepared. 5

6 1.6 Who are the members of the M-SAA Advisory Committee? A: The M-SAA Steering Committee is composed of executive leaders with representation from LHINs, Community Sector Associations, HSPs, and the Work Group Leads. 2. Education & Supporting Documents 2.1 Within the CAPS Reference Overview (both English and French versions), the first graphic within Section 3 is not fully visible. A: These documents have been corrected and they are now available on the website of your LHIN. 2.2 In the CAPS HSP Orientation presentation, the embedded audio does not play. A: This depends on the version of PowerPoint being used. Some versions will display an audio control bar when you mouse over the speaker icon, whereas other versions may require that you double-click the speaker icon to play the audio. Please note that the file must be saved as a ppt file not a pptx file for the audio to play correctly. 3. Planning 3.1 How will LHIN-specific goals and objectives be integrated and reflected in the M-SAA and CAPS? A: HSPs will have an opportunity to comment on how their operations and future plans will fit with their LHIN s Integrated Health Services Plan (IHSP) in the CAPS Part A Service Plan Narrative. LHINs will also have the opportunity to consult with their HSPs and include local performance expectations in the M-SAA. LHINs are cognizant of the burden on HSPs and will therefore be cautious in the inclusion of local indicators. 3.2 Are we planning for no across-the-board increases for all 3 years? A. HSPs should be planning for three years and assuming a 0% increase throughout the 3 year period. HSPs are encouraged to discuss their concerns with their LHIN representative. 3.3 With a 0% increase over the next 3 years, do HSPs have the flexibility to redistribute dollars and/or activity within their existing budget? A: Service enhancements that can be accommodated within the planning assumptions can be included in the CAPS. If, however, an HSP is considering a service target reduction to meet the 0% funding assumption, the HSP must initiate a discussion with their LHIN representative and obtain pre-approval. This may require the submission of a Service Delivery Change Form or another document at the discretion of the LHIN. 6

7 3.4 With a 0% increase over the next 3 years, is it alright for the planning targets for , and to be the same? A: Yes, for Years 2 and 3 the expectation is that planning targets will be repeated from Year 1. LHINs may choose to refresh the Schedules of the M-SAA for and by requesting that HSPs submit another CAPS with whatever new financial or statistical information is available at that time. 3.5 With a 0% increase over the next 3 years, how do HSPs address pressures? A: The LHINs understand that HSPs are facing cost pressures as a result of successive years of little or no funding increases. The LHINs are well equipped to discuss options with you, whether they be integration opportunities, agreements for shared services such as finance or HR between HSPs, or ways to optimize efficiency. Please contact your LHIN representative to discuss your particular situation and explore possible solutions. 3.6 How does an HSP record short-term funding from Other Funders (eg. United Way) when it is not known whether the funding will be received entirely within one fiscal year? A: The answer to this question depends on the particular situation. Please contact your LHIN representative to discuss this issue and determine the best approach. 3.7 Is it possible for an HSP to redistribute funding that was provided in the past for a particular Functional Centre? A: The answer to this question depends on the particular situation. Please contact your LHIN representative to discuss this issue and determine the best approach. 3.8 Should an HSP add new programs to the CAPS that were approved in ? A: Any new base funding received within prior to the time an HSP completes its CAPS should be reflected in the CAPS. Please discuss with your LHIN. 3.9 Is there another form (service delivery change form) to fill out for changes to the services offered by an HSP? A. If an HSP is planning to change service or discontinue any services funded by the LHIN, the HSP must alert its LHIN prior to submitting the CAPS. The process to address these changes, whether through a Service Delivery Change Form or another approach, is determined by each LHIN Can administrative costs be offset by recoveries made by a levy on other funding (eg. Trillium grant, midwifery TPA role)? A: The answer to this question depends on the particular situation. Please contact your LHIN representative to discuss this issue and determine the best approach. 7

8 3.11 How does an HSP record administrative costs if it is still ramping up operations? A: The HSP should be submitting a CAPS based on the full operations of the HSP. If there is a ramping up period, then the HSP should identify this in the comments section where these costs would appear in the CAPS and alert the LHIN to this How can Physician vacancies be recognized in the CAPS? A prolonged vacancy might swing the proportion of budget spent on administration by 1% or so. A: In the case when there is any position vacancy the HSP should still be planning for this vacancy to be filled in their CAPS. It is essential to discuss any re-allocation of unspent funds as a result of a position vacancy with your LHIN before reallocating. HSP comments in the CAPS tool are essential to fully understanding variances and unexpected results. The LHIN strongly encourages HSPs to provide these additional comments as appropriate to fully explain the HSP s position Where can we find information that would help us determine or compare unit costs across the LHIN and across the province? A: Comparative information on unit costs may be found on the Ministry of Health and Long-Term Care, Health Data Branch Portal at the following address: How do HSPs budget for projects in response to LHIN Request of Proposals (RFPs)? A. The answer to this question depends on the particular situation. Please contact your LHIN representative to discuss this issue and determine the best approach. 4. Reporting 4.1 On the identification page of the CAPS form do we need to complete both the Recipient Number and Facility Number sections. A: Yes, both are mandatory. The Recipient Number can be found on the Payment Allocation Notice. The Facility Number is the number that identifies the Trial Balance report. 4.2 How will an HSP know if any definitions have changed within the OHRS since the last CAPS ( )? A. HSPs are encouraged to review the section(s) of the OHRS that corresponds with the services they offer. The OHRS are available on the Health Data Branch Web Portal at Generally, any changes made from the previous version are highlighted in yellow within the OHRS. If an HSP has any questions about the OHRS, they are encouraged to contact the Ministry of Health and Long-Term Care by via the address below that corresponds with the services they offer: Community Care Access Centre Community Health Centres OHRSCCAC@ontario.ca OHRSCHC@ontario.ca 8

9 Community Mental Health & Addictions Community Support Services 4.3 Do Administration Costs include meals provided to clients? A: No, Administrative Costs do not include direct costs of serving clients. If meals are provided within a particular program, the associated costs should be recorded in the Functional Centre for that program. Please refer to the OHRS for clarification regarding the reporting of administrative expenses. 4.4 Can rent costs be included as Administration since OHRS identifies rent as a possible administration cost? A: Functional Centre frameworks are intended to separate and distinguish activity costs associated with administering a healthcare facility from the activity costs of delivering specific healthcare or services. The OHRS states for 7* 1 55 Plant Operations, rental or lease space can only be reported in Plant Operations and Marketed Services (OHRS v8.1, Chapter 4, p. 9). Additionally, the OHRS affirms that rent, which varies by organization, is NOT a direct cost of delivery of service and it is not to be taken into account in the calculation of unit or service cost (OHRS v8.1, Chapter 10, p. 9). 4.5 Who is responsible for reporting the financial and statistical information when an HSP is funded by the LHIN to sub-contract a service or program to another service provider? A: The HSP receiving the funding from the LHIN is accountable for the services that are provided with the funding and must therefore report associated financial and statistical information. This is the case whether the services are sub-contracted to another LHINfunded HSP or to another agency. 4.6 How should CHCs report their LHIN-funded programs when some Functional Centres listed within CAPS Parts A & B are not at the Functional Centre reporting level (level 5)? A: The CAPS and Community Quarterly reports are not intended to replicate the granularity of the reporting within the Trial Balance submissions. In order to limit the number of statistical rows, the CAPS and Community Quarterly reports currently require service recipient activity to be reported at a rollup level of the statistical accounts specified within the OHRS. In order to also limit the number of Functional Centres reported, some are currently specified at a higher level (eg versus , , , etc.). One limitation of this approach is that the number of Individuals Served will not be a measure of the number of unique individuals, since uniqueness is determined at the full Functional Centre level (level 5). For CHCs, the number of Individuals Served for Functional Centres that are specified at the rollup level within the CAPS and Community Quarterly reports should be the sum of the unique Individuals Served in each of the Functional Centres within the rollup. This will allow the LHINs to validate this data against what is reported within the Trial Balance reports. 9

10 4.7 What should CHCs report within the Budget (Historical) column on the Activity Planning Page for Functional Centres that were not included in the previous CAPS? A: CHCs will set targets for Functional Centre rollups within the CAPS. As no historical targets exist, CHCs are asked to manually enter their service activity targets from the previous CAPS within the Undistributed Accounting Centres 82* section of the Activity Planning Page. Once the Functional Centre targets have been entered for , , and , the LHINs will be able to assess the balance between the historical year ( ) and the three planning years on the Total Cost for All Functional Centres and the Total FTEs for All Functional Centres lines, displayed at the bottom of the Activity Planning Page. 4.8 What is an example of Other Medical Staff on the Finance Screen listed under Medical Staff Remuneration? A: Physician Locum MD- Fee for Service This account is used to record the compensation paid to a medical practitioner with respect to a contractual agreement, between the health care organization and the physician, pertaining to the provision of medical services based on a schedule of fees which describes specific services and sets out the fee that shall be charged for each service rendered. 4.9 Will HSPs involved in Health Links be required to submit projections for service targets within the Functional Centre Provincial & Regional Health System Development? A: Yes, service targets associated with Health Links funding will need to be populated under Functional Centre Provincial & Regional Health System Development. Please discuss any concerns with your LHIN representative Does Hours of Service include both In-House and Contracted Out hours? A. Yes, Hours of Service reporting on the Activity Planning Page includes both In-House and Contracted Out hours How can an HSP modify the statistics that are reported for a Functional Centre if some of the rows listed on the Activity Planning Page do not apply to a particular service? A. On the activity screen, click on the Show All button at the top left of the screen to show all Functional Centres. Next, click on the M button to the right. Scroll down through the Functional Centres and delete the M on the row for whatever activity is not reported by your Sector and type in M on any row for activities that are reported by your sector. Click on the Show HSP Specific button at the top left of the screen to display the Functional Centres and the revised service activities to be reported for your agency How does an HSP report Service Provider Interactions if they are required for a Functional Centre? A: For instructions on modifying the rows that are visible on the Activity Planning Page, please see question This will allow the user to designate the Service Provider 10

11 Interactions as mandatory. Service Provider Group Interactions should be reported under Group Participant Attendances How does the OHRS account for differences in resource intensity within the reporting of Service Provider Interactions? A. Within Version 8.1 of the OHRS, new statistical accounts have been added to provide clarification around the time interval for each Service Provider Interaction. Please refer to the Full Provincial Statistical Account List within the OHRS for further details. This document is available within the Ontario Healthcare Reporting Standards section of the Health Data Branch Web Portal at Please note that the CAPS and Community Quarterly reports are not designed to replicate the detailed information that is reported within the Trial Balance reports. As a result, the number of Service Provider Interactions that is reported within the CAPS and Community Quarterly reports is the sum of all Service Provider Interactions for all time intervals combined What is the difference between A2-1 and A2-2 within Part A of the CAPS? A: HSPs are requested to list the services they deliver and the geographies served within Schedules A2-1 and A2-2. Within Schedule A2-1, HSPs are requested to enter information for their services that are funded entirely or in part by the LHIN. Within Schedule A2-2, HSPs are requested to enter information for their services that are not funded by the LHIN. If a service name within the dropdown menu in the Service field is not a meaningful description of the service, the HSP can key-in their own description Is the Description of Services A2-2 used for Fund Type 3 only? A. The Description of Services A2-2 section is intended to describe services provided by an HSP that are not funded by the LHIN. 5. Submitting 5.1 What is the deadline for the submission of the CAPS? A: Both Part A and the CAPS report are due to your LHIN on or before November 15, Will the deadline be extended? A: It is not anticipated that the deadline for CAPS submission will be extended. HSPs are encouraged to discuss any extenuating circumstances with their LHIN representative as soon as possible. 5.3 Will there be some leeway for Municipalities that are unable to obtain Council approval of their CAPS by November 15 due to the pre-booked dates of their Council meetings? A: The CAPS forms are due by November 15, However, if a Municipality expects a delay in obtaining CAPS approval due to timing of its Council meetings, the HSP is encouraged to formally advise its LHIN. The LHIN will discuss options with the HSP and 11

12 may decide to accept a draft version by November 15 and a final submission as soon as Council approval is possible. 5.4 How will HSPs submit the CAPS forms? A: Part A of the CAPS must be ed to your LHIN via the address that has been provided to you. If you are unsure of this address, please contact your LHIN representative. The CAPS report containing the completed Financial and Statistical information should be submitted via the SRI system. 5.5 Does the CAPS need to be Board-approved? A: Yes, the CAPS must be approved by the Board of Directors of the HSP prior to submission. A signature of the Board Chair is not required for submission of the CAPS, but will be required once the new M-SAA agreement with its Schedules is issued to the HSP. 5.6 Why does the HSP not have the option to click No Change within the Description of Services and Population and Geography Narrative sections of Part A of the CAPS for A: While clicking No Change was an option within the CAPS, the present CAPS submission is the beginning of a new three year M-SAA and the LHINs are looking for full descriptions in these sections even if nothing has changed from the previous year. The LHINs wish to ensure all relevant details are reported in Part A. If none of the services provided by the HSP have changed, the HSP may choose to copy and paste information from a previous CAPS submission. 5.7 Why is there variability between LHINs on the date that the CAPS has to be submitted? A: The deadline for the submission of the CAPS is November 15, Why is there variability between LHINs on whether to plan targets for only one year or three years? A: The Provincial directive is that the CAPS are to be completed for all years of the 3 year term of the M-SAA: , , and Why is the Budget (Historical) column in the CAPS blank? A. Please refer to question How can an HSP correct information in the CAPS if it has been imported incorrectly from the CAPS file? A: The data within the Budget (Historical) column of the CAPS is imported directly from the CAPS file that has been uploaded to the SRI system. The data migration process has also been validated through User Acceptance Testing. In some cases, the CAPS data that was migrated into the report was for 12

13 another Health Service Provider as a result of an error in the labeling of the CAPS file. If you experience any issues with the importation of the historical data, please contact the SRI Helpdesk at sri@ontario.ca or An HSP can also overwrite the data that has been imported within the Budget (Historical) column When uploading the CAPS file to SRI, can an HSP change the name of their CAPS file? A. HSPs can change the filename of their CAPS after they have downloaded it from SRI. SRI does not validate the Excel filename, but will check the content of the file. For this reason, it is important that the file that is uploaded whatever it is named - be the exact same file that was downloaded from SRI. HSPs must ensure they do not upload any other Excel files to SRI, otherwise they will receive a system error by and their data will not be saved to SRI database If a CAPS file is Checked In within SRI, but not submitted, can it be Checked Out again? A. Once the HSP has Checked In the file within SRI, it cannot be Checked Out again unless the report is Returned by the LHIN. If an HSP needs to make adjustments to their CAPS after it has been submitted, they are encouraged to contact their LHIN representative to Return the file within the SRI system Should an HSP report service activity related to its entire corporation or just the volumes that are associated with LHIN-funded programs? A. Service activity targets should relate only to programs that are LHIN-funded. 6. Indicators 6.1 Will the LHIN be reconsidering the target set for the Proportion of Budget Spent on Administration indicator for ? A: The Proportion of Budget Spent on Administration is a core indicator within the M-SAA to which all HSPs are held accountable. The approach for setting a target for this indicator is determined by each LHIN. HSPs are encouraged to discuss their concerns regarding their target for this indicator with their LHIN representative. 6.2 Who is responsible for the creation of the provincial indicators? A: The M-SAA Indicator Work Group includes members from LHINs, the MOHLTC and various community sectors. This Work Group will develop the indicators found in the M-SAA in collaboration with the pan-lhin Health System Indicator Initiative. The list of indicators will be endorsed by the M-SAA Advisory Committee and approved by the LHINs before they are included within the M-SAA. 13

14 6.3 How will M-SAA indicator targets be determined? A: The pan-lhin Health System Indicator Initiative and the M-SAA Indicator Work Group will identify appropriate performance indicators and provide guidance regarding target setting and appropriate performance corridors. Following the submission of the CAPS, LHINs and HSPs will discuss performance indicator targets appropriate to the organization and local circumstances. HSP specific performance targets will be expected to reflect performance and drive continuous improvement. Where provincial targets or clinical benchmarks exist, the LHINs and HSPs will take these into consideration. 6.4 Will the LHINs provide definitions for indicators, performance targets and performance standards? A: Yes, a Technical Specifications document for the indicators is being prepared by the M- SAA Indicator Work Group and will accompany the release of the indicators. 6.5 When is there an opportunity to renegotiate Functional Centre targets or MSAA indicator targets? A: Performance indicators will be negotiated locally with HSPs following the completion and review of the CAPS. Service enhancements that can be accommodated within the planning assumptions can be included in the CAPS. If, however, an HSP is considering a service target reduction, the HSP must initiate a discussion with their LHIN representative and obtain pre-approval. 14

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