Background Document - Medical Equipment and...

CENTRAL COMMUNITY CARE ACCESS CENTRE

BACKGROUND INFORMATION DOCUMENT

RFP for Medical Equipment and Equipment-Related Supplies

August 2015

Table of Contents

Page

CCAC Vision & Mission 1

Background of CCAC 1

Central CCAC Main Office Sites 2

Central CCAC Nursing Clinic Sites 2

CCAC Mandate 3

Central CCAC’s 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

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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 Ontario’s 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 CCAC’s 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.

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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

Sheppard

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

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CCAC Mandate:

The Central CCAC is one of 14 CCACs that play an important role in Ontario’s 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 CCAC’s 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

� Nursing

� Personal Support

� Physiotherapy

� Occupational Therapy

� Speech-Language Pathology

� Social Work

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� Dietetics

� 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

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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 CCAC’s 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

Age

Average

Length of

Stay (days)

# Patients

on Service

per Month

% of Total

Resources

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%

Community

Independence

75 293 39,552 9.4%

Short Stay – Acute 60 54 2,520 6.8%

Short Stay

Rehabilitation

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 patient’s 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.

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� 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 CCAC’s 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. John’s Rehab

� St. Joseph’s Morrow Park Infirmary & Private Hospital

There are 46 long-term care homes in Central CCAC’s 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

� Lifelabs

� Matthews House Hospice

� Medigas

� Nursing & Homemakers Inc.

� Ontario Medical Supply Inc.

� Paramed Home Health Care

� Preferred Health Care Services Inc.

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� 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.

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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

needs.

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 LHIN’s 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.

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Central

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

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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

Units

Ordered

Number of

Rental Days

Average

Length of

Stay(Days)

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

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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

year.

Central CCAC Owned Equipment Inventory

Item Number of

Owned Units

Total Number

of Annual

Orders

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

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