There will be no more funding for the Muskoka and Area Health System Transformation (MAHST) council, but its work will continue, according to Jill Tettmann, CEO for the North Simcoe Muskoka Local Health Integration Network (NSM LHIN).
“We plan on continuing to move forward with the vision and the model of care for an integrated system,” said Tettmann.
The NSM LHIN is a Crown agency, which responds to the Ministry of Health and Long-Term Care to plan, co-ordinate and fund public health care services in the communities it serves. NSM LHIN looks after five sub-regions and Muskoka is one of them. The NSM LHIN endorsed the creation of MAHST in the spring of 2016, and provided the council with $200,000 in funding.
MAHST was formed by various community stakeholders, most of whom volunteered their time to look at how health care is delivered in Muskoka and surrounding communities. Its formation came on the heels of a letter signed by roughly 60 primary care providers in late February, 2016, who indicated they were willing to look at the entire system, including their own role, in order to find greater cohesion and more savings in the system to maintain two acute care hospitals in Muskoka. They came together following a recommendation by the board of Muskoka Algonquin Healthcare (MAHC), which manages both the Bracebridge and Huntsville hospitals, which called for a single acute care hospital site for the region, rather than the existing two. They were also responding to a joint resolution by the municipalities of Huntsville and Bracebridge to keep two sites going. They were concerned that only one of those two sites would offer acute care services. (You can find more about that here.)
When MAHST was formed, many hoped that a system restructuring would indeed net enough savings to save Muskoka’s two fully functioning hospital model. Unfortunately, it appears that may have been simply wishful thinking. When Doppler interviewed MAHST co-chair Don Mitchell in May, he indicated that the hospitals were simply one more health care provider in the big picture. (You can find that interview here.)
In a presentation to Huntsville Council by MAHST on July 10, just days after MAHC issued a release stating it had received one million dollars from the Ministry to proceed with its capital planning process, the future of acute care in Huntsville under a newly proposed health care model was conspicuously missing. (You can find that story here.)
Then, when MAHC went before council on July 24, its chair stated that she did not believe enough savings could be found through MAHST to maintain two fully functioning hospitals. (You can find that story here.)
MAHST provided its final report to the board of the NSM LHIN in July. It made a series of recommendations and implementation strategies to strengthen and streamline health care delivery in Muskoka and its immediate surrounding communities. It also recommended the creation of a local corporation with “service management, delivery and coordination capabilities.” The plan also included a system improvement proposal that asked for $815,000 for the remainder of the year and ongoing annual funding of roughly $1.2 million, starting in 2018/2019.
Neither the creation of a separate corporation at the grass roots level, nor the funding request was approved by the Board, which released a joint statement with MAHST on September 27, which you can find here (PDF).
Following the release, Tettmann indicated that the NSM LHIN will continue with the work of MAHST. She also indicated that the mandate of the LHINs has changed significantly since MAHST was created.
“Our mandate has changed in the last three, four months. Our mandate has changed fairly significantly when we went through the merger with the CCAC and through the Patients First Act where we’re being asked to take on a much more proactive role at a sub-region level, Muskoka and area would be considered a sub-region, a much more proactive role in integration,” she explained. “With the Patients First Act we have reorganized the LHIN and we now have resources at the sub-region level. So we have what we’re calling a triad, it’s basically three people that now have responsibility to do integrated planning at the sub-region level.”
Those three NSM LHIN employees are Director of Planning and Integration Beth Ward, Director of Home and Community Care Monica Gabriel, and the LHIN has hired Dr. David Mathies, who will provide primary care support, one day a week.
“The three of them will be working at the sub-region level to look at the directions… out of the MAHST report, which is, as we’ve said, starting to look at opportunities to further integrate primary care, home and community care and mental health and addiction. So that will be part of their role, to do some of that work. Dr. Mathies is already working with a group of primary care physicians. He’s already engaging a number of physicians. A lot of primary care physicians and others were part of the MAHST general council and I expect that they will continue to be involved as we move forward,” said Tettmann.
Both Ward and Mathies have been part of MAHST.
“When we started MAHST we gave them one-time funding of $200,000 to support some of the work that they needed to be doing. So we’ll now be taking some of that project management support on and moving forward with recommendations alongside MAHST,” said Tettmann, adding, “we are planning on bringing a group together shortly after Thanksgiving weekend.”
What that sub-region planning group will be called is yet to be determined. It could continue to be called MAHST as the name has traction in the community. Either way, the group will comprise some of the same people who sat on MAHST, said Tettmann. “I would say that, particularly the general council that was involved with MAHST, if they are still interested in moving this forward and working on better patient care then they’ll be involved… everybody that wants to be involved in continuing to support improving health care and access and all of that for patients in Muskoka, will be involved.”
When asked where the hospitals fit into the big picture, Tettman said: “They were part of the MAHST general council and I think there was a member of the hospital board that sat on the executive council… and they will continue to be involved as we move forward.”
You can find MAHST’s final report, as presented to the NSM LHIN, here.
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