Background Document - Medical Equipment and...

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    RFP for Medical Equipment and Equipment-Related Supplies

    August 2015

  • Table of Contents


    CCAC Vision & Mission 1

    Background of CCAC 1

    Central CCAC Main Office Sites 2

    Central CCAC Nursing Clinic Sites 2

    CCAC Mandate 3

    Central CCACs Strategic Priorities, Goals and Objectives 3

    Services Provided by CCAC 3

    Central CCAC Volume Statistics 4

    Central CCAC Patient Profile 4

    Settings Where Services Are Delivered 5

    CCAC Partners/Stakeholders 6

    Central CCAC Patients by Age 8

    Central CCAC Budget 8

    Population & Demographics of Central LHIN Area 8

    Key CCAC Statistics 9

    Central CCAC Medical Equipment and Equipment Related Supplies 10

    Attachment 1 Boundary Map of Central LHIN/CCAC Area

  • Page 1 of 11

    Background of the CCAC:

    The Central Community Care Access Centre (CCAC) has a very diverse geography. Our

    catchment area includes the northern section of Toronto, most of York Region and the

    southern part of Simcoe County. Please refer to Attachment 1 for a map outlining the

    geographic boundaries of Central CCAC.

    Central CCAC is the largest of Ontarios 14 CCACs in terms of population; however we

    are the third smallest in terms of geographical size. Our population density is 40 times

    greater than that of Ontario as a whole.

    The Central CCACs population is broken down as follows: 40% in the city of Toronto,

    17% in Markham, 14% in Vaughan and 11% in Richmond Hill and the remaining 18%

    living throughout the remaining geography. Although the geography is primarily urban,

    it does have a significant rural region in the north, which can represent challenges to

    residents when accessing services.

  • Page 2 of 11

    Of the roughly 1.8 million residents, Central CCAC provided service to over 82,500

    people in the 2014-15 fiscal year or 36,500 patients on any given day. This service is

    delivered through approximately 700 CCAC employees as well as through the staff of 23

    contracted service provider agencies.

    The changing needs of our patients require that we redefine patient-centred care.

    Central CCAC service providers will be expected to work collaboratively with the CCAC

    and other health care partners to develop innovative and effective models of service

    delivery to meet the needs of patients in our geography.

    Central CCAC Main Office Sites:

    Newmarket Richmond Hill

    1100 Gorham Street, Unit 1 9050 Yonge Street, Ste. 400

    Newmarket, Ontario L3Y 8Y8 Richmond Hill, Ontario L4C 9S6

    Phone: 905 895 1240 Phone: 905 763 9928


    45 Sheppard Avenue East, Ste. 700

    North York, Ontario M2N 5W9

    Phone: 416 222 2241

    Central CCAC Nursing Clinic Sites:

    CCAC Clinic - Newmarket CCAC Clinic - Markham

    York Medical Building Boxgrove Medical Arts Centre

    #1 - 17215 Leslie Street #100 110 Copper Creek Drive

    Newmarket, Ontario L3Y 8E4 Markham, Ontario L6B 0P9

    CCAC Clinic Vaughan CCAC Clinic - Alliston

    Vaughan Health Campus of Care Stevenson Memorial Hospital

    #121 - 9401 Jane Street Outpatient Dept Room 213

    Vaughan, Ontario L6A 4H7 200 Fletcher Crescent

    Alliston, Ontario L9R 1W7

    CCAC Clinic Keele CCAC Clinic - Branson

    Humber River Hospital North York General Hospital

    E221 - 2175 Keele Street #224 - 555 Finch Avenue West

    Toronto, Ontario M6M 3Z4 Toronto, Ontario M2R 1N5

    CCAC Clinic Fairview

    Fairview Health Centre

    5 Fairview Mall Drive, Suite 108B

    Toronto, Ontario M5G 1Z8

  • Page 3 of 11

    CCAC Mandate:

    The Central CCAC is one of 14 CCACs that play an important role in Ontarios health

    system by coordinating quality in-home and community-based care for over 650,000

    people each year. Services provided by the CCAC include nursing, personal support and

    therapy services, as well as specialized services such as rapid response nursing, mental

    health and addictions nurses in schools, palliative care and child and family services.

    We also help people of all ages understand and choose from a wide range of health,

    community and social services, so they can live independently at home for as long as

    possible. These options include adult day programs, retirement homes, assisted living

    and supportive housing, and short- or long-term care.

    The mandate as stated in the Community Care Access Corporation Act, 2001 is:

    To provide, directly or indirectly, health and related social services and supplies and

    equipment for the care of persons.

    To provide, directly or indirectly, goods and services to assist relatives, friends and

    others in the provision of care for such persons.

    To manage the admission of persons into long-term care homes (LTCH).

    To provide information to the public about community-based services, long-term

    care homes, and related health and social services.

    To cooperate with other organizations that have similar objectives.

    Central CCACs Strategic Priorities, Goals and Objectives:

    At the heart of the Central CCAC Strategic Plan (2014-2017) are three priorities for

    action over the next two years.

    Quality through Integrated Care

    Quality through Access to Care and Services

    Quality through Optimizing Patient Outcomes

    Services Provided by the CCAC:

    Care Coordination

    Access to long-term care homes

    Information & Referral


    Personal Support


    Occupational Therapy

    Speech-Language Pathology

    Social Work

  • Page 4 of 11


    Medical Supplies

    Infusion Supplies and Equipment

    Medical Equipment

    Laboratory Services

    Access to Adult Day Programs

    Medication Management Support Services

    Central CCAC Volume Statistics:

    Service 2014-2015 2013-2014

    Visits Visits

    Nursing 688,025 642,027

    Nursing Shift*, including hospice 318,109 287,735

    Nursing in community clinics 93,051 67,391

    Personal Support*, including hospice 3,428,549 2,999,082

    Occupational Therapy 50,528 49,195

    Physiotherapy 173,014 91,829

    Speech Language Pathology 51,949 51,940

    Social Work 1,670 1,453

    Nutritional Counselling 4,882 4,642

    *Personal Support and Shift Nursing Services are reported in Hours

    Central CCAC Patient Profile:

    Central CCAC serves an increasing number of patients with complex, chronic health

    conditions. Over 73% of patients have very high or high need compared to 56% just five

    years ago.

    Patients expectations are also changing. They are better informed, and expect their

    values, culture, beliefs and personal circumstances to be understood and respected

    when it comes to decisions about their care. Evidence shows that patients who are

    engaged in their care have better outcomes and a more positive experience with the

    health system.

    At the same time, public sector organizations, particularly in health care, are expected

    to improve patient outcomes by delivering quality care while demonstrating value for

    the taxpayer.

    Patients, care partners, researchers and policy experts all agree that better planning and

    coordinated care is required for complex patients as they shift from receiving care in the

    hospital to the community. Helping patients to transition to different care settings, such

  • Page 5 of 11

    as, from hospital to home, mobilizing health, community, and support services through

    integrated, individualized care plans and accessing the right services for patients this is

    where the CCAC comes in.

    Central CCACs commitment is that patients and caregivers will be an integral part of

    their health care plan even when we are not able to meet all of their expectations.

    They will know who to call at the Central CCAC about their care plan and services, what

    to expect, and be informed about the benefits and risks of different choices.

    Central CCAC uses a common provincial assessment tool to determine the needs of

    adult patients. Service plans are then developed to meet the identified needs. The table

    below sets out some of the primary characteristics of the various patient populations.

    Population Average



    Length of

    Stay (days)

    # Patients

    on Service

    per Month

    % of Total


    Complex Adult 78 474 2,870 25.5%

    Complex Child 7 278 256 4.3%

    Chronic Adult 79 395 9,587 36.5%

    Chronic Child 8 371 715 3.7%



    75 293 39,552 9.4%

    Short Stay Acute 60 54 2,520 6.8%

    Short Stay


    75 62 1,713 1.9%

    Short Stay Oncology 59 131 548 1.4%

    Not Identified 63 61 206 0.6%

    Home First 81 53 255 3.9%

    School 8 513 4,593 6.0%

    Settings Where Services are delivered:

    Health and support services for patients are delivered in the community. Settings

    include but are not limited to:

    The patients residence, whether a permanent or temporary home, and may include

    a group home, retirement home, rest home, or home for special care

    Long-term care homes

    Community settings where the patient may need assistance from the service

    provider in carrying out their day-to-day activities, e.g., shopping centres, medical

    offices, recreation centres, workplace (occasionally). Also, the CCAC will provide the

    required services in settings where community support agencies offer their services

    and programs.

  • Page 6 of 11

    Publicly and privately-funded schools

    CCAC clinic locations

    Central CCAC provides services to residents on Georgina Island, Snake Island, and Fox

    Island. Access to the islands is provided by Island Transportation (either ferry,

    airboat or ice road access)

    CCAC Partners/Stakeholders:

    There are 10 hospitals located within Central CCACs catchment area:

    Don Mills Surgical Unit

    North York General (including the Branson site)

    Humber River Hospital (including Finch, Church & Keele St sites)

    Markham Stouffville Hospital

    Shouldice Hospital Limited

    Southlake Regional Health Centre

    Mackenzie Richmond Hill Hospital

    Stevenson Memorial Hospital

    St. Johns Rehab

    St. Josephs Morrow Park Infirmary & Private Hospital

    There are 46 long-term care homes in Central CCACs catchment area. The CCAC

    provides care coordination services to assist people with their short stay respite,

    convalescent care and long-term care placement needs. The CCAC also provides short-

    term nursing and speech language pathology services to eligible patients in long-term

    care homes.

    Central CCAC has service agreements with the following organizations:

    1to1 Rehab Inc.

    Bayshore Home Health

    Calea Ltd.

    Cancare Health Services Inc.

    CBI Health Group

    Circle of Home Care Services

    Closing the Gap Healthcare Group

    Hill House Hospice


    Matthews House Hospice


    Nursing & Homemakers Inc.

    Ontario Medical Supply Inc.

    Paramed Home Health Care

    Preferred Health Care Services Inc.

  • Page 7 of 11

    Prohome Health Services Inc.

    Regional Nursing Services

    Revera Health Services

    Saint Elizabeth Health Care

    Shoppers Home Health Care

    Spectrum Health Care

    The Speech Clinic

    SRT Med-Staff

    VHA Home Healthcare and VHA Rehab Solutions

    VON Canada

    We Care Health Services Inc.

    There are approximately 105 private schools and 8 publicly-funded school boards in the

    Central CCAC catchment area.

    The CCAC works closely with and is actively involved in cooperative/partnership

    initiatives with many of the community support agencies that provide services

    throughout the Central region.

    The CCAC collaborates with many stakeholders, such as the Ministry of Health and Long-

    Term Care, the Central Local Health Integration Network (LHIN), local hospitals and

    other local health system partners such as community support agencies, to meet health

    system priorities. Central CCAC is committed to working with all system partners to

    maximize the resources that are available within the health and community support

    system. It is essential to build capacity of all health care service providers in order to

    meet the needs of the aging population as well as the complexity of their care.

    Central CCAC is committed to supporting the Central LHIN in the development and

    implementation of strategies that will help seniors stay healthier and to live

    independently at home and in their community.

  • Page 8 of 11

    Central CCAC Patients by Age:

    Central CCAC Budget:

    The 2015-2016 budget for Central CCAC is approximately $267 million. Central CCAC is

    challenged by the increasing number of patients as well as the complexity of their care


    Population and Demographics of Central LHIN Area:

    The Central region has the largest proportion of immigrants (48 per cent of residents)

    among the LHINs, and the second highest visible minority population (42 per cent of

    residents). We have the highest proportion of residents (4.5 per cent) who report no

    knowledge of either official language.

    In 2006, just over half of the LHINs population reported English as their mother tongue

    (the lowest rate among the LHINs) and only 1.2 per cent included French as their mother

    tongue (the second lowest percentage in Ontario). We also have the lowest number (0.4

    per cent) of Aboriginal/First Nations people.

    The proportion of the population considered low-income is the second highest in

    Ontario, at almost 18 per cent. Among children, poverty rates are even higher in some

    parts of our LHIN. In Markham-Unionville, 22.5 per cent of children live in poverty; in

    Richmond Hill, the rate is nearly 20 per cent.

  • Page 9 of 11


    LHIN Ontario

    Total Population (2011) 1,768,550 13,372,996

    Population Aged 65+ 12.5% 14.2%

    Population Aged 75+ 5.8% 6.6%

    Population English Mother Tongue 51.5% 69.8%

    Population French Mother Tongue 1.2% 4.4%

    Population with no knowledge of either official language 4.5% 2.2%

    Population Immigrants 48% 28.3%

    Population Visible Minority 42.1% 22.8%

    Population Aboriginal Identity 0.4% 2%

    Population Completed Post-Secondary Education, aged 25-64 66.6% 61.4%

    Population Living in Low Income 17.7% 14.7%

    Key CCAC Statistics:

    2015-2016 Budget $286 million

    Number of Employees 700

    Number of patients served in 2014-15 82,587

    Number of patients on service on any given day 36,437

    Largest Referral Source within Central LHIN in

    2014-2015 Humber River Hospital

    Largest Referral Source Outside Central LHIN in

    2014-2015 Sunnybrook Health Sciences Centre

  • Page 10 of 11

    Central CCAC Medical Equipment and Equipment-Related Supplies:

    It is important for CCAC service providers to have a detailed description of all the

    products along with a picture showing exactly what each product looks like. The

    successful respondents will be required to provide Central CCAC with an electronic copy

    of a picture catalogue which can be shared with our contracted service providers. These

    medical equipment picture catalogues provide service providers with a valuable

    resource and decreases the number of product errors and repeat deliveries.

    The estimated number of deliveries in the first agreement year by delivery type as

    outlined in the delivery price form is provided using Central CCAC historical and recent

    data, service delivery request patterns throughout the Central CCAC geography,

    consultation with other CCACs, and data from the current Central CCAC vendors.

    The table below is a summary of the total number of units ordered, rental days and the

    average time that each item was in the home for the top 10 most utilized Medical

    Equipment rentals in the 2014-15 fiscal year at Central CCAC.

    10 Most Rented Items

    Number of



    Number of

    Rental Days


    Length of


    Electric Hospital Bed 1,554 44,448 29

    Partial Bed Rails for Hospital Bed 1,139 27,971 25

    Commode Stationary unpadded 959 17,578 18

    Therapeutic Surface - Advanced Pressure

    Relief 358 16,349 46

    Overbed Table 438 12,341 28

    Full Bed Rails for Hospital Bed 285 12,277 43

    Walker wheels 5 regular pair 415 10,689 26

    Therapeutic Surface Basic Pressure

    Relief 445 10,578 24

    Bed Helper 248 9,292 38

    Therapeutic Surface Intermediate

    Pressure Relief 316 8,783 28

  • Page 11 of 11

    The table below is a summary of the number of CCAC owned units, including the current

    number of units for each item as well as the total number of orders in the 2014-15 fiscal


    Central CCAC Owned Equipment Inventory

    Item Number of

    Owned Units

    Total Number

    of Annual


    Therapeutic Surface - Atmosair 9000 40 132

    Therapeutic Surface - First Step Select - Air Rail 23 72

    Therapeutic Surface - First Step Select - Excel 2 12

    Therapeutic Surface - Pressure Guard 1 1

    Therapeutic Surface - RIK 1 4

    Therapeutic Surface - Therakair Visio 23 42

    Hospital Bed - Electric Low Bed w/ Foam Mattress 102 200

    Hospital Bed - Electric Hospital Bed w/ Foam

    Mattress 42 84

    Hospital Bed - Bariatric Bed Frame 2 1

    Falls Prevention Floor Mat 20 50

    Sit-to-Stand Life Sling - Size XS 5 1

    Sit-to-Stand Life Sling - Size SM 5 1

    Sit-to-Stand Life Sling - Size MD 5 1

    Sit-to-Stand Life Sling - Size LG 5 1

    Sit-to-Stand Life Sling - Size XL 5 1

    Sit-to-Stand Life Sling - Size XXL 5 1

    Sit-to-Stand Lift 5 1

    30" Wheelchair 2 1

  • Attachment #1