Business and Operational Plan Examples by xld14276

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									Business and Operational Plan Examples
                                                                           Page 2
Business and Operational Plan Examples                        Page Guide*
                                                               #   Reference
A. Introduction                                                3
  A1) Introduction and Instructions                            3
B. Executive Summary                                           5
C. Business Plan                                               7
  C1) Governance                                               7      4.1.1
  C2) Vision, Mission and Strategic Objectives                 11     4.1.2
  C3) Population Characteristics, Health Data and Access
                                                               16     4.1.2
  to Care
  C4) General Information and List of Programs and Services    22     4.1.3
  C5) Summary of Business Plan Timelines                       28      4.2
  C6) Financial Forecast                                       28      4.3
D. Operational Plan                                            29
  D1) Core, Optional, and Special Services/Programs            29   5.1.2/5.1.3
  D2) Human Resources and Recruitment Plan                     34      5.1.4
  D3) Collaborative Team Practice                              38      5.1.5
  D4) Physical Site Preparation                                40      5.1.6
  D5) Information Technology and Electronic Medical Records    44      5.1.7
  D6) Extended Hours/ Telephone Health Advisory Service        47      5.1.8
  D7) Other Programs                                           47      5.1.9
  D8) Evaluation                                               48     5.1.10
  D9) Consolidated Timelines                                   52       5.2
  D10) Annual Resource Requirements/Budget                     52       5.3
E. Quick Reference Sheet                                       54    App. C
F. Appendices                                                  55
  Appendix A – Job Descriptions                                55
  Appendix B – Location details - quotations, estimates for
  renovations etc.
                                                               61
  Appendix C – Transitional One-Time Cost Details              62
  Appendix D – Timelines                                       63
  Appendix E – Financial Forecast/Budget                       68
G. Acknowledgments                                             77
H. Where to Get More Information                               78
   * Guide to Business and Operational Plan Development
                                                                                                                      Page 3

                                           A. Introduction
A1) Introduction and Instructions
Purpose
This template accompanies the Guide to Business and Operational Plan Development and is
meant to assist you in developing your Business and Operational Plan. It comprises two
sections: the Business Plan and the Operational Plan.

These examples have been drawn from actual plans that have been submitted to the
Ministry for review and are being provided here with the permission of the authors after
having been changed to remove identifying information. The Ministry is appreciative
for these Teams sharing their plans to assist others in moving forward with their own.

Background
The Business Plan provides a multi-year overview of Family Health Team planning and
resource requirements. It should set out elements such as the governing structure, vision,
mission, population characteristics, and an overview of programs and resources.
The Operational Plan is completed on an annual basis (by fiscal year) for each of the 5
fiscal years and provides detail on the major activities for implementing each year of the
Business Plan.

Every Family Health Team's plan will be different and should reflect the population
needs, the availability of health human resources and the local availability of other
complementary health and social services. The samples have been chosen to try to
illustrate how plans will differ based upon governance, size, and community and
population needs. These samples are a compilation of a variety of plans for each of the
sections of the Business and Operating Plans and should not be read as a whole but rather
as examples of good practice for each of the sections.

Layout of Template/Instructions
Each section provides a reference to the relevant guides available on the ministry
website1 and a summary of requirements. All guides referenced in the Template are
hyperlinked2 to the Guides themselves on the ministry website. The front page of the
Business Plan Template is also hyperlinked to the corresponding section in the Template
itself. Most sections also include either a sample response, a sample template, or a sample
of the type of issues to be addressed in each section. Please note that all examples may
not be relevant to your submission.




1
  For Family Health Team guides visit http://www.health.gov.on.ca/transformation/fht/fht_guides.html
2
  A hyperlink or simply a link, is a segment of text that serves as a reference between parts of a document, to another
document, or to a website. To follow the link, simply place your cursor on the blue underlined text, hold Ctrl, and
left click.
                                                                                                                                           Page 4

                 The Business Plan and Operational Plan Cycle

         9. What criteria should we use to evaluate and determine if
                                                                                     8. What are the major challenges to success and how
         we have achieved our objectives?
                                                                                                    can they be managed?



                                                                                                               7. What resources are
                                                                                                                    required?
1. Where are we now?
                                                                Operational Plans:

                                                                               Plan for
                                                                               Implementing
                                        Business Plan:          Transition     Family                                       6. How long will it
                                                                Period         Health Team                                  take and what are
                                                                                                                            the key milestones
                                        Rationale for                           Services                                     in getting there?
                                        Proposed Family
                                        Health Team
2. What are our goals?                  Services



                                                                                                    5. What is the best avenue and what will
            3. What is our rationale/justification for                                                             it involve?
                             them?
                                                  4. What are the different avenues to
                                                               get there?
                                                                                                      Page 5

                              B. Executive Summary
 REQUIREMENTS:
 • Please provide an executive summary of your submission.



SAMPLE RESPONSE

Background/Executive Summary
The XYZ Family Health Team is a group of 7 family physicians, together with a broad range of
interdisciplinary health providers, who will offer comprehensive primary care to the citizens of
Appleville and the surrounding area.

The group is committed to: patient-centred care; creating a teaching and learning environment
for patients and for health care providers; practicing medicine in an economic and ecologically
sustainable environment; a focus on wellness, prevention, and effective management of chronic
disease/conditions; efficient and effective use of a broad range of allied health professionals and
existing community resources; seamless systems for patient access and referral.

The Group’s Mission Statement is:
“to provide exemplary interdisciplinary patient care and excellence in clinical teaching in a
sustainable healthy environment.”

This Family Health Team will offer service to approximately 10,000 patients from Appleville
and from the townships of O, P, and Q. Over a 5-year period, the patient load will double,
providing new access to residents of the region who currently do not have a family physician.
Most of the practice associated with this Family Health Team will be located in SITE 1
beginning in June 2006. There are plans to secure an additional SITE 2 for an additional five
family physicians by 2007/2008.

Patients will be persons from all demographic categories. The SITE 1 and 2 offices are urban
sites, while the Site 3 office is a rural site.

In addition to the provision of primary care, the XYZ Family Health Team will focus on
education; a significant focus of the Team will be on providing patient education in a variety of
formats, including one-on-one consultations and educational/teaching sessions aimed at illness
prevention, wellness, and management of chronic conditions. Targeted programs will focus on
Diabetes, Asthma, Osteoporosis, Smoking-related cancer, and Cardio-Vascular illness.

The Family Health Team will be results-oriented, and will practice a model of ongoing learning
and evidence-based medicine. The physicians and interdisciplinary providers will work together
to maximize the effectiveness of the interdisciplinary team. Nurses and nurse practitioners will
be the cornerstone of the team. The roles they play and the services they provide will fully
utilize their knowledge and skills; their duties will go beyond the duties of the typical practice
nurse. The effective use of all of the team members will improve patient satisfaction, improve
                                                                                                    Page 6

health status, and create capacity for the Team to provide service to residents of Appleville who
currently lack access to primary health care.

The use of information technology (IT) is paramount to the successful recording of patient
encounters and medical records and as a research and communication tool for all of the medical
professionals in the Team. Timely access to the patient’s medical and demographic information
will be another vital component that will contribute to the successful integration of the team.

In total, we are proposing a first year budget of $XXX, the allocation of which consists of 80%
for medical resources (representing XX FTE positions) and 20% in overhead costs. The first
year budget contains over $XXX in capital expenses primarily for the renovations required at
Site 1 and for information technology requirements.

This Family Health Team will also provide leadership in continuing medical education and
teaching opportunities for physicians.
                                                                                                Page 7

                                   C. Business Plan
The Business Plan provides a multi-year overview of Family Health Team planning and
resource requirements. It should set out elements such as the governing structure, vision,
mission, population characteristics, and an overview of programs, and human resources.


C1) Governance
Please refer to the Guide to Business and Operational Plan Development, section 4.1.1 and the
Guide to Governance & Accountability to help you complete this section.

 REQUIREMENTS:
 • Please provide:
      o Your Family Health Team name and contact information. The Ministry
           requires that the name includes “Family Health Team”;
      o The name of legal entity that will receive and be accountable for funding;
      o The name of Authorized signing officer;
      o The Bank Account details for funds: name of bank, bank account
           number, branch address, account holder name;
 • Briefly describe the governance and accountability mechanisms in your Family
   Health Team, including:
      o Current governance model (e.g. FHN, none), and legal arrangement.
      o The new governance model (e.g. community, provider, mixed) your
           Family Health Team will espouse and a list of the providers and/or
           community groups who are joining your Team.
      o The new legal arrangement (not-for-profit, partnership, etc.). Based on
           RESPONSE
 SAMPLE the options in the Guide to Governance and Accountability, describe the
           legal arrangement of your Team.

   SAMPLE RESPONSE
   Name of Family Health Team          Contact Information          Lead Physician’s Name and
                                                                         Mailing Address
  ABC Family Health Team         Tel: 124-321-6549               Dr. Martha French
                                                                 123 Street Ave.
                                 Fax: 123-654-7894               City, ON A1A 2B2

                                 Email: name@email.ca



 Current               Proposed       Participants           Current            Proposed
 Governance            Governance                            Legal              Legal
 Structure             Structure                             Arrangement        Arrangement
 Provider-based        Mixed          XYZ FHN, ABC           Professional       Partnership
                                      Hospital               Corporation
Page 8
                                                                                                     Page 9

SAMPLE RESPONSE


                             1.1      MODEL OF GOVERNANCE


XYZ Family Health Team will be a provider-based Family Health Team.

Physicians are sole providers working under an informal non-incorporated group of Association,
called the XYZ Family Practice. The XYZ Family Practice receives funding under a RNPGA
Contract with the Ministry of Health for six (6) FTE Physicians. There are nine (9) physicians in
the group of Association, who share the funding for six (6) physicians.

A full-time business administrator reports directly to all the physicians.

All Family Health Team healthcare professionals will provide input to the facilitation and
administration of programs and services provided by the Family Health Team by participating on
committees, which may include physician, administration and community representation.

                          1.2      SPONSORING ORGANIZATION

The name of the sponsoring organization that will receive and is accountable for funding is the
XYZ Family Practice.

The XYZ Family Practice will receive the funding for the XYZ Family Health Team, and will
set up a separate accounts ledger for this funding on their financial books. This will be the same
bank account that is being used for RNPGA funding to the group.

                                1.3   NAME OF ASSOCIATION

The name of the organized Association will be XYZ Family Health Team (XYZ FHT).

Contact Information:            XYZ Family Health Team
                                14 Street, PO Box # 123
                                XYZ, Ontario
                                A0B 2B1
                                P: (123) 155-4568
                                F: (123) 546-9872
                                Att: M. Tremblay, Clinic Administrator
                                e-mail: mtremblay@email.on.ca
                                                                                             Page 10


                                 MINISTRY OF HEALTH                                      Decisions
                                                                                         are
                                                                                         Consensus
                            XYZ FAMILY HEALTH TEAM BOARD                                 Based!


                                                                                    Implement
                                                                                    Business
  Direction & Accountability                                                        Plan!


                                  Decisions
                                  are               FAMILY HEALTH TEAM ADMINISTRATOR
                                  Consensus
                                  Based!
XYZ FHT PROVIDERS                                          Governance & Administration
• Physicians                                                         Finance
• Social Worker                                            Human Resource Management
                                                              I.T. & Communication
• Nurse Practitioner
                                                            Structure, Space & Design
• Registered Nurse
• Registered Dietician
• Visiting Cardiologist

                                                           XYZ FHT Executive Assistant


      Note:
      Meeting &                                            XYZ FHT ADMINISTRATIVE
      Committee Structure                                  AND SUPPORT STAFF




Monthly Meetings:                             All XYZ FHT Providers Group Meeting
                                              Board of Governors & XYZ FHT Administrator
Committees for Program Development:           Mental Health Program Committee

Committees for Logistics & Infrastructure:    Structure & Space
                                              Finance
                                              I.T. & Communication
                                                                                                Page 11

C2) Vision, Mission and Strategic Objectives
Please refer to the Guide to Business and Operational Plan Development, section 4.1.2, and to
the Guide to Strategic and Program Planning. It is recommended that you use the Strategic
Planning Template for Family Health Teams (Guide to Strategic and Program Planning, p.9) to
assist you in completing this section.

 REQUIREMENTS:

 In this section, please address the following questions and ensure that information
 requested in the Guide’s “Strategic Planning Template for Family Health Teams” is
 provided.

 •   Vision Statement:
     o Describe the long-term goal of your FHT
     o Develop a vision statement which should reflect your commitment to
        improving the health of individuals in your community

 •   Mission Statement:
     o Outline the purpose of your organization to reflect your commitment to
        improving the health of individuals in your community
     o Highlight the services your FHT will provide to achieve its vision – such as
        accessibility, comprehensive care, health promotion and chronic disease
        management programs

 •   Strategic Objectives
     o Develop objectives that are measurable and meaningful. These objectives
         should concentrate on major responsibilities, be patient-centered, and
         focused on outcomes, such as impact, quality, patient satisfaction, timelines
         and efficiency

 •   Strategies
     o Develop strategies and will contribute to achieving the objectives your team
         has set out. A number of strategies may be proposed – some may already
         exist in the community, others may need to be developed to address gaps in
         health services. Each Family Health Team will need to prioritize and link to
         existing programs where appropriate, to achieve its objectives, coordinate
         services, and reduce gaps and duplication of services
                                                                                                         Page 12

SAMPLE RESPONSE

Vision, Mission & Values

The following vision, mission and value statements have been developed to guide the work of
the ABC & Area Family Health Team:

VISION
   ‘A patient centered primary health care system, which provides model collaborative health care,
                        successful in improving the health of our community’

MISSION

 ‘Maintain and improve the health of the people it serves, by providing increased and timely access to
                                        primary health care’

VALUES

As an organization:

   We value and are committed to delivering Patient-Centred Health Care
   We are committed to ensuring Quality Care for all patients
   We will strive to provide patients with Timely Access to care
   We value and respect the Rights and Needs of each Patient
   We are committed to ensuring a Balanced Work/Lifestyle for all participating members of the FHT
   We value Collaboration amongst all stakeholders within the Family Health Team
   We value and promote continuous Learning
   We are committed to individual and organizational Accountability
   We will maintain and uphold Ethical practices

Patient-Centred Practice Model

In serving the population of the catchment area the Family Health Team is proposing to
implement a patient-centered service delivery model. Within this approach, all services will be
planned, coordinated and delivered based on the needs of the patient. The patient/consumer will
guide the scope and range of services to be delivered, and service delivery will be flexible to
respond to the changing needs of the patient population.

Strategic Objectives

The Strategic Objectives outlined in the following table provide the framework to guide the
future delivery of primary health care services by the ABC & Area Family Health Team. This
team will be focused on shifting the emphasis from treatment to prevention of illness, injury and
disease, reducing hospital admissions and supporting patients to more effectively manage
chronic disease conditions.
                                                                                                                                    Page 13


STRATEGIC OBJECTIVES


1.                    2.                     3.                             4.                               5.
To Develop a          To Provide             To Provide Quality             To provide Enhanced              To Provide Effective
Comprehensive         Patients with          Health Promotion and           Screening and Early              Treatment & Enhance
Interdisciplinary     Timely Access &        Prevention Services to         Identification of Disease.       Strategies for Managing
& Patient-            Effective              Reduce Injury and                                               Chronic Diseases.
Centred Primary       Coordination of        Disease.
Health Care           Services                                                 *Secondary                       *Tertiary
Team                                            * Primary                       Prevention                       Prevention
                                                 Prevention
                                                                                                             (*Preventing further
                                             (*Preventing disease &         (*Screening for possible         disease and complications
                                             injury from developing ‘In     existing disease processes)      of existing conditions +
                                             the first place’)                                               Treatment of existing
                                                                                                             disease)

                                     Essential Components of Programming & Service Delivery

Interdisciplinary     Enabling patients to   Prevention of disease and      Early detection & diagnosis      Provide evidence-based
team of doctors,      have timely access     injury integrated and          through increased access to      program approach to
nurses, nurse         services such as       emphasized in all FHT          diagnostic services such as      patient’s needs re disease
practitioners and     acute care, long-      strategies                     PACs-accessible X-ray,           management.
other healthcare      term care, public                                     ultrasound, Bone Density
professionals         health, mental         Health Promotion programs      Studies, Cardiac Screening &     All health care providers
working together      health and             designed to enable patients    Peripheral Venous Studies,       working from common
with Patient a        addictions programs    to prevent illness, disease    breast and prostate screening,   patient-centered
member of the         and professionals,     and injury,                    Laboratory studies               goals/common health
team                  and increased access                                                                   record/ongoing
                      to new and existing    Provide health education &     Target Diseases:                 communication re
Expanded access       community              support programs not           •   Cardio-vascular              progress & needed
to care through the   programs and           currently available in the     •   Breast /Lung                 revision to care approach
Telephone Health      services               system, empowering the             /Prostate/Colon Cancer
Advisory Service                             patient & positively           •   Diabetes                     Provide self care &
(THAS) and 24/7       Organized efficient    impacting individual,          •   Osteoporosis                 education programs
availability of       patient-friendly       family and population          •   Others – based on need
MDs                   approach to case       health                                                          Provide or enable access
                      management                                                                             to minor surgical
Knowledge                                                                                                    procedures through ABC
dissemination as                             Target Diseases/                                                FHT professionals or
keystone of                                  Injuries/High risk                                              Visiting Specialist
improved health                              conditions:                                                     program
status                                       •    Smoking-related
                                                  Cancers, heart &                                           Ensure patients have
Evidence-based                                    respiratory disease                                        timely access to major
programs and                                 •    Injuries: Falls & other                                    surgery an other services
practices, CQI,                                   accidents/MVCs/                                            outside community when
Risk Management                                   Poisonings                                                 required
& Accountability                             •    Suicide
practices in use in                          •    Drowning                                                   Expand & Enhance End
all programs &                               •    Substance abuse                                            Of Life care services and
services                                     •    Infection                                                  support
                                             •    Teen Pregnancy
                                                                                                        Target Diseases:
                                             •    Hypertension
                                                                                                        Cardio-vascular illness:
                                             •    Others – based on                                     CHF, MI, Stroke; cancer;
                                                  need
                                                                                                        Diabetes; Depression;
                                                                                                        Substance Abuse; Obesity;
                                                                                                        Others
             All programs will be developed and offered in collaboration with partner organizations wherever possible
                                                                                                  Page 14

By focusing on these strategic objectives, existing health care professionals and organizations
will be more closely linked and better able to adapt their services to meet the health needs of the
community. Ongoing collaboration and participation at the governance level will facilitate the
realization of these Strategic Directions.

* It is anticipated that the Family Health Team (once operational) will conduct more detailed
planning on an annual basis to identify specific service objectives and targets to be achieved.
Annual service delivery data can then be compared to baseline data (available at the time of FHT
implementation) to enable on-going monitoring, assessment and evaluation of this new model of
primary health care delivery.
                                                                                                              Page 15

SAMPLE VISUAL REPRESENTATION OF VISION, MISSION STATEMENT AND
STRATEGIC OBJECTIVES

                       Strategic and ProgramPlanning O              ily
                                                      utline for Fam Health Teams



                                            Vision Statement




                                            Mission Statement




    Strategic Objective #1                Strategic Objective #2               Strategic Objective #3




ProgramA           ProgramB                    ProgramA                    ProgramA           ProgramB
O bjective #1      O bjective #1                Objective #1               O bjective #1      O bjective #1
O bjective #2      O bjective #2                Objective #2               O bjective #2      O bjective #2



Program             Program                                                 Program            Program
                                           ProgramStrategies
Strategies         Strategies                                              Strategies         Strategies



Resources          Resources                   Resources                   Resources          Resources
                                                                                                Page 16

C3) Population Characteristics, Health Data and Access to
    Care
Please refer to the Guide to Business and Operational Plan Development 4.1.2 and to the Guide
to Strategic and Program Planning to help you complete this section. It is recommended that
you use the Strategic Planning Template for Family Health Teams (Guide to Strategic and
Program Planning, p.9) to assist you in completing this section.

 REQUIREMENTS:
 • Please provide a description of your Family Health Team’s population
   characteristics, health data and access to care.
 • Please cite the data provided in your response.

SAMPLE RESPONSE

3.1 Population Characteristics*

Numbers
It is estimated that the total population within the proposed ABC FHT is approximately 12,000.
At present there are 3295 active patients who are registered with the three existing community
physicians and one nurse practitioner. There are also 3881 patients who are registered to
physicians who have left the community or who have moved to practice in nearby communities
outside of the ABC and area catchment area.

Demographics
The most notable demographic characteristics of the area’s catchment population
(impacting health status) include the following:

• Language
The total proportion of residents in the catchment area which report English as their
mother tongue is 76.9% which is slightly higher than the provincial rate of 71.6%.
However, 17.3% of the ABC and Area population identify that French is their mother
tongue which is significantly higher than the provincial rate of 4.4%.

• Aboriginal Origin
8.2% of ABC & Area’s total catchment population is of aboriginal origin while the
province’s average is 1.67%. This population is underreported through Census data and
local officials identify that LMN and PQR populations are significantly higher than
reported.

• Employment Income
The average employment income for all census subdivisions in the ABC & Area
catchment is slightly lower than the provincial average of $35,185 except for Anywhere
District which is more than $4,000 higher than the provincial average.
                                                                                                   Page 17

Women in all parts of the catchment area earn significantly less than the provincial
average for women $26,894 – (ranging from $16,425 in Somewhere River to $20, 576 in
Anywhere District)

• Low-Income Families
The total percentage of low-income families in the ABC & Area catchment area is 14.2%
which is higher than the provincial rate of 11.7%.

• Average Household Income
The average household income in the catchment area is lower than the provincial average
of $66,836 (the lowest income is Somewhere River $42,774, while the highest is
Anywhere District $60,362.)

• Social Assistance
The proportion of the ABC & Area catchment area population which receives social
assistance or other government transfers is 21.2% which is more than double the
provincial rate of 9.8%.

• Education
A slightly higher proportion of the area’s 15-24 year old population does not attend school
(38.8%) compared to the province (35.1%). The proportion of the population aged 20
years and over within the catchment area which has a university education is 10.6% which
is less than half the provincial rate of 26.3%.

• Employment
Within the ABC & Area catchment the unemployment rate is nearly double the provincial
rate for all age groups with the highest rate of unemployment being experienced by males
in the 15-24 year category at 34.9% compared to the provincial rate of 13.2%.

• Labour Force-Occupations
The top 3 occupational groups (which account for nearly 63% of the total occupations in
the ABC & Area catchment) are: Sales & Service (26.8%), Trades, Transport &
Equipment Operators & Related Occupations (23.8%) and Business, Finance &
Administration Occupations (12.0%).

• Lone-Parent Families
There are a total of 420 single parent families within ABC & Area of which more than
75% are headed by a female.

Health Status
There is significant data which reveals that the overall health status of residents within the ABC
& Area catchment is poorer than the rest of the province. The population is one of the oldest in
Ontario and has considerably high rates of diabetes, cancer and cardiovascular disease. The
prevalence of these diseases is exacerbated by the fact that the region has one of the highest rates
of smoking and a population with a higher than average body mass index (BMI) due to a
predominantly sedentary lifestyle. The area’s population also has higher rates of binge drinking
and injuries and is faced with high levels of unemployment and a lower annual income than the
provincial average.
                                                                                                 Page 18

Health status indicators for this population have been well documented in a variety of public
health unit, district health council, hospital and provincial health research organizations and
some of these key indicators include the following:
• Increased levels of morbidity and mortality for a range of chronic conditions such as
   diabetes, respiratory illnesses and cardiovascular conditions than the rest of the province,
   which increases the need for long term care (LTC) services.
• Higher rates than average of morbidity and mortality, with reduced years of life from various
   cancers, respiratory illnesses, cardiovascular disease, accidents and suicide.
• Death rates due to injuries, poisoning and suicide are alarmingly higher in the entire district
   compared to province.
• Deaths due to circulatory diseases are disproportionately higher.
• Higher rates of smoking, leading to higher rates of morbidity and mortality for lung cancer
   and heart disease. 27% of males in the district smoke daily compared to 23% in province.
   26% of women smoke daily compared to 18% provincially.
• Teen birth rates are consistently higher, as much as 39-63% higher than the province.
• 13.4% of the population in XYZ have a long-term disability, while the provincial average is
   9.6%
• Lower utilization of cervical screening
• High use of hospital emergency departments by residents in the ABC area, in 2002-03
   residents visited hospital ER 84% higher than the provincial experience.
• Total ER visits in ABC is normally between 14,400 and 15,000 per year
• 94.28% of all patients presenting to the ER in ABC are either a level 4 or 5, meaning they are
   not urgent patients. The provincial average is 59.7%. This is significant, reflecting the lack
   of primary care providers in the community. Patients are forced to access the ER for simple
   things such as prescription renewals.
• Higher proportion of Francophones in the region as compared to the province; Francophone
   population tend to be older than the rest of the population in Ontario as a whole; they tend to
   have lower levels of education and income; higher rates of bronchitis-emphysema, asthma
   and hypertension compared to the rest of the province population; there are a higher
   proportion of Francophones who smoke on a regular basis
• Aboriginal origin population much higher than rest of Ontario, with significantly higher rates
   of Diabetes and resulting complications, as well as other health issues related to the
   determinants of health such as education, income and access to culturally sensitive health
   services. Mental health and social services are lacking, with substance abuse and suicide at
   higher levels than the rest of the population

Note: Further research is needed in the area of Needs Assessment for the First Nations
population within the ABC & Area FHT’s catchment area. A partnership may be sought with the
Research and Development Institute of the Anywhere & District Health Unit regarding this
important issue.
                                                                                                                                 Page 19

4.0        The External Environment
4.1    Catchment Area
The geographic area to be served by the proposed FHT is extensive and includes a 50 km
radius centred out of the Town of ABC. This catchment area includes a number of
neighbouring communities (townships) such as: M, N, and T, 2 Native Reserves, and
Anywhere District. A map of this proposed catchment area has been provided.
4.2     Population
The total number of health consumers to be served by the ABC & Area FHT is approximately
12,000. This includes the total population figures provided for all available census subdivisions
in the catchment area (11,193) as well as estimated populations served in the surrounding Native
Reserves. In terms of population distribution by age, the largest proportion of the population
within ABC and area is the 40-59 year old group which comprises almost 32% of the total
population. The next largest group is the 0-19 year old group at 26% of the total population
followed by the 60-79 year old cohort which comprises 16% of the total population. A
breakdown of this catchment population by age is outlined in the table below.

Population by Age Groups: Statistics Canada, Census 2001
                                  Ontario    Town A and    Town B     Town A        Town C        Village D        City E
                                                Area
Population, 1996 - 100% Data      10,753,573      11,946      3,535       5,796          694              456          2,929
Population, 2001 - 100% Data      11,410,046      11,193      3,245       5,449          624              420          2,910
Population percentage change,            6.1        -6.3       -8.2        -6.0         -10.1            -7.9           -0.6
1996-2001
Land area in square kilometres,     907,656       18,793       806             82            82           159       35,327.6
2001

Total population by sex and age   11,410,045      11,190      3,245       5,445          625              420          2,910
groups - 100% Data
  0-4                               671,250         555        195         250               35               25        100
  5-9                               772,650         768        230         390               30               35        165
  10-14                             788,850         795        230         395               35               40        190
  15-19                             769,415         833        250         415               45               35        175
  20-24                             718,420         493        140         255               35               15            95
  25-29                             729,655         535        170         260               20               25        120
  30-34                             828,840         633        180         320               30               30        145
  35-39                             989,840         885        250         435               35               45        240
  40-44                             969,670        1,030       280         530               50               35        270
  45-49                             859,130         945        285         440               65               25        260
  50-54                             776,145         915        250         420               65               35        290
  55-59                             584,495         670        180         300               35               25        260
  60-64                             479,500         628        190         265               35               25        225
  65-69                             430,880         535        150         245               30               20        180
  70-74                             387,290         390        110         200               20                5        110
  75-79                             313,795         285         80         160               15                0            60
  80-84                             190,135         200         50         125               10                5            20
  85+                               150,070         108         25             70            10                0             5
NOTES:
   “ABC and Area” has been developed by summing together the Somewhere River, ABC, D, E and F, and 50%
   of the Anywhere census subdivisions.
   Totals and percentages may not always add up due to the effect of rounding.
                                                                                                                   Page 20

Population Distribution by Sex
According to the table provided below it appears that the distribution of population by sex is very
evenly divided between males and females. Females make up 50.3% of the total population
while males account for 49.7% of the total. The most significant difference between males and
females is that there are a larger proportion of females (65%) within the 75+ year age groups
indicating that the life expectancy of women is longer than their male counterparts.

Population by Sex: Statistics Canada, Census 2001
                  Ontario         ABC         Somewhere      ABC         D         E and F         Anywhere
                                and Area        River
Male, total         5,577,055         5,570          1,630     2,640         315             215        1,540
 0-4                 343,340           300            100          135       20              20               50
 5-9                 396,385           398            125          190       20              20               85
 10-14               404,970           408            115          205       15              20           105
 15-19               394,915           418            120          215       25              15               85
 20-24               359,645           258             75          135       15               5               55
 25-29               356,180           255             80          115       10              15               70
 30-34               404,515           295             80          150       15              10               80
 35-39               487,605           420            130          195       20              20           110
 40-44               476,230           518            140          260       25              20           145
 45-49               419,475           468            140          225       30              10           125
 50-54               382,065           485            130          215       40              20           160
 55-59               288,120           358             90          165       10              20           145
 60-64               232,445           303             95          125       15              10           115
 65-69               205,785           283             80          115       20              10           115
 70-74               177,845           190             65           85       10               0               60
 75-79               130,435           115             35           60        5               0               30
 80-84                71,835            80             20           45        5               5               10
 85+                  45,260            38             10           20        5               0                5


Female, total       5,832,990         5,628          1,620     2,810         305             210        1,365
 0-4                 327,910           255             95          115       15               5               50
 5-9                 376,265           370            105          200       10              15               80
 10-14               383,880           388            115          190       20              20               85
 15-19               374,500           415            130          200       20              20               90
 20-24               358,775           235             65          120       20              10               40
 25-29               373,475           280             90          145       10              10               50
 30-34               424,325           338            100          170       15              20               65
 35-39               502,235           465            120          240       15              25           130
 40-44               493,440           513            140          270       25              15           125
 45-49               439,655           478            145          215       35              15           135
 50-54               394,080           430            120          205       25              15           130
 55-59               296,375           313             90          135       25               5           115
 60-64               247,055           325             95          140       20              15           110
 65-69               225,095           253             70          130       10              10               65
 70-74               209,445           200             45          115       10               5               50
 75-79               183,360           170             45          100       10               0               30
 80-84               118,300           120             30           80        5               0               10
 85+                 104,810            70             15           50        5               0                0
                                                                                            Page 21

4.3    Community Resources
There are a number of existing primary care providers and community resources which would
complement the proposed ABC & Area Family Health Team. These include some of the
following:
       ABC General Hospital
       ABC Nursing Home
       CCAC
       Optometrists
       Dentists
       Registered Massage Therapist
       Chiropractors
       ABC Family Medical Clinic: currently staffed with 3 physicians (community
       complement is 6)
       Everywhere Mental Health Clinic
       VON Canada
       Specialists: Pediatrics, Cardiology, ENT, Ophthalmology, Internal Medicine /
       Infectious Diseases, Minor Surgery, OB/GYN, Audiology, Podiatry, Chiropody
       ABC and District Association for Community Living
       XYZ District Social Services Advisory Board
       Local Area Medical Clinics (including First Nations)

4.4    Environmental Factors
The Town of ABC is home to a large pulp and paper mill currently being operated by ZYXW
which is the community’s largest employer.

* Statistics Canada. 2001 Census. www.statcan.ca/Daily/English/020716/td-3/716.htm
                                                                                        Page 22

C4) General Information and List of Programs and
Services:
Refer to the following guides as you complete this section:
• Guide to Business and Operational Plan Development section 4.1.3
• Guide to Chronic Disease Management and Prevention
• Guide to Health Promotion and Disease Prevention
• Guide to Collaborative Team Practice
• Guide to Community Funding Partnerships and Program/Service Integration
• Guide to Patient Enrolment

 REQUIREMENTS:

 •   Confirm your intention to provide, or ensure the provision of the full spectrum
     of core/comprehensive Family Health Team services;
 •   Provide details on the current population being served (if applicable) and
     estimates of additional patients/clients to be served and how this will be
     achieved;
 •   Provide a list of physicians and other primary health care providers required to
     provide these services – clearly differentiate between existing and new
     providers;
 •   Provide anticipated dates for recruitment of new providers;
 •   Indicate compensation mechanisms proposed for physicians (current and new);
 •   Specify location(s) where services will be provided;
 •   Indicate whether any renovations are required to enable provision of services;
 •   Indicate where after hours services will be provided;
 •   Provide information on current numbers of enrolled patients/clients (if
     applicable) and anticipated numbers to be enrolled in future (with estimated
     timelines);
 •   For all participating physicians, indicate if any are practicing under other
     alternative funding agreements and which type of agreements they are currently
     members of.
                                                                                         Page 23

SAMPLE RESPONSE

                                General Information

Core/Comprehensive Services

The XYZ Family Health Team affirms that it will provide a full spectrum of
comprehensive Family Health Team services.

Current population to be served

There are 8,000 individuals rostered or affiliated with the XYZ Family Health Network.

Additional population to be served

Until the successful completion of the three to four year operational plan described
herein, there will continue to be orphans and individuals that have to obtain their
primary care either out of county or from non-FHT physicians.

Orphans

Orphans are defined as individuals in XYZ (determined by postal code) that are not
currently under the care of a physician or nurse practitioner. In conjunction with the
implementation of Seniors Health, Healthy Kids, Healthy Living, Chronic Disease
Management, Healthy Kinetics, End-of-life, Telehealth and Enhanced Mental Health
services, the teams will establish care maps or protocols for delivery of selected
services to residents of XYZ without a primary care practitioner. In many cases, these
services will be delivered in a group format.

Other Primary Care Provider

Individuals who receive primary care from other primary care providers outside of the
FHT will be able to access selected services of Seniors Health, Healthy Kids, Healthy
Living, Chronic Disease Management, Healthy Kinetics, End-of-life, Telehealth and
Enhanced Mental Health Programs. Again, protocols will be established to guide the
movement of the individual through the program and communication with their
primary care practitioner. In both circumstances, the FHT will work with the EMR
vendor to establish a reliable method to capture non-enrolled/affiliated patient
encounters. These encounters will be monitored, and trends in utilization will be
identified.
                                                                                                                                    Page 24

Physicians and Primary Health Care Providers


Provider Type                                           Existing                          New FHT
                                                        FHN
Family Physician                                        8 (=6 FTE)*(FHN                   12 (=10FTE)
                                                        funding)
Nurse Practitioner                                      0                                 4 FTE

Registered Nurse Lead                                   0                                 5 FTE

Practice Nurse                                          2.0 FTE                           2.0 FTE

(Clinic RN)                                             (FHN funding)                     (FHN funding)

Clinic Registered Practical                             0.5 FTE (FHN                      0.5 FTE (FHN funding)
Nurse                                                   funding)
RPN – Telehealth Coordinator                            0                                 0.5 FTE

Social Worker                                           0                                 1 FTE

Registered Dietitian                                    0                                 1 FTE

Psychogeriatrician                                      0                                 0.5 FTE

Pharmacist                                              0                                 0.5 FTE

Case Manager / System                                   0                                 1.0 FTE contract
Navigator (Year 3)
Cardiologist                                            visits                            1 – contract / sessional

Paediatrician                                           visits                            1 – contract / sessional

Internist                                               visits                            1 – contract / sessional

Orthopaedic Specialist                                  visits                            1 – contract / sessional

Psychiatrist                                            visits                            1 – contract / sessional

General Optometrist                                     0                                 1 - sessional

Paediatric Ophthalmologist (yr. 3)                      0                                 1 – space and support

Specialist - Other                                      0                                 Unknown - sessional

*Physician FTE’s based on actual provision of primary care in office setting, either at FHN clinic or in walk-in. Some physicians
practice part-time or are otherwise occupied with on-call/emergency duties for the hospital and long-term care, teaching
responsibilities, medical director responsibilities at Long-Term Care Facilities and committee work.
                                                                                                Page 25

Recruitment Timelines
Please refer to Figure 10 for estimated timelines in recruitment of the required Health Human
Resources.




Compensation mechanisms for Physicians

Physicians are partners in a Family Health Network and compensated through a blended
capitation model. Any additional physicians selected to join the FHT will be included in this
model.

Location of Services and Programs

At full operation, all Family Health Team services and programs will be offered in both DEF and
surrounding villages. A selection of services will be provided on an outreach basis to satellite
locations, such as QR.
                                                                                                    Page 26

Location readiness

A Family Health Centre is under construction. The two-storey, 20,000 square foot structure has
been determined to accommodate health services only. Physicians will be able to relocate to the
new facilities in March 2006.

In 2004, the municipality of OPQ et al. undertook these plans to construct a new location for the
physicians; upon hearing about the planned Family Health Team, they promptly doubled the
planned square footage to accommodate additional health services. These additional health
services, including Interdisciplinary Health Professionals of the Family Health Team will be
offered out of the first floor of the Family Health Centre. The expected timeline for renovations
of allied health professionals’ space is the summer of 2006. One-Time, non-recurring capital
funding is being requested to contribute towards the securing of the building. One-time funding
that is received will be considered in the development of a rental agreement with OPQ et al,
realizing operational cost-savings. Floor plans of the 1st and 2nd floors of the XYZ Family
Health Centre are appended.

Diagnostic Services
Laboratory and X-Ray Services are available both City X and City Y. Ultrasound
services are available in XYZ.

Outreach Locations
Given the lack of transportation in the outlying areas, satellite services will be provided to
underserviced isolated communities once primary care practitioners are recruited.
The Municipality of VU has partnered with the Family Health Team to provide
office/clinic space in the village of Somewhere. This space will be able to
accommodate primary care practitioners and other Interdisciplinary Health
Professionals.

Location of after-hours services

After-hour physician services will be provided out of the adjacent emergency rooms,
where physicians are remunerated through an Alternative Payment Plan. In XYZ, the
physicians that staff the emergency room are the group of physicians that make up the
XYZ Family Health Network.

Once the XYZ Family Health Team is at full capacity, the need for and the feasibility
of an after-hours primary care clinic will be assessed in both City X and City Y. This
may be staffed by a complement of Nurse Practitioners, in collaboration /consultation
with the on-call physician.

After-hours allied health services and programming will be offered out of both
locations to meet client needs and reduce barriers to accessing these services.
                                                                                           Page 27

Information on current numbers of enrolled clients

There are 8,000 individuals rostered or affiliated with the XYZ Family Health Network.

Anticipated enrolment with estimated timelines

The Family Health Team is estimating timelines for two scenarios. In the first scenario,
“Plan A”, the FHT will be successful in all its Recruitment Goals and will have
recruited 4 RN (EC) s and 4 family physicians. With this complement of primary care
practitioners, 16,000 individuals can be enrolled/affiliated with the FHT for primary
care by the beginning of Year 4.

Recent dedicated recruitment efforts have not produced one family physician in the past
5 years. With this in mind, the FHT has also proposed a “Plan B”, in which by the end
of the third year of operation, it will become apparent whether or not family physicians
will successfully be recruited to the area and to this model. In “Plan B”, the FHT will
recruit 6 additional RN (EC)s during Year 4 to meet the primary care needs of the
region. With this alternative complement of primary care practitioners, 16,000
individuals can be enrolled or affiliated with the FHT by the end of Year 4. Please see
Figure 11 for a graphic description of timelines for both Plan A and B.

Figure 11 – Anticipated Primary Care Enrolment / Affiliation Timelines




Physician alternative funding agreements

The Family Health Network physicians have an alternative payment agreement with
XYZ Health Services to staff the Emergency Department.
                                                                                                                                             Page 28

C5) Summary of Business Plan Timelines
Please refer to the Guide to Business and Operational Plan Development, section 4.2.,

 REQUIREMENTS:
 • Provide a timeline incorporating the key elements identified in your multi-year
   Business Plan.


SAMPLE TEMPLATE
 Augus     Sept.      October      November         December       January       February      March       April    May       June    July
   t
 Formative Stage-------------------------------------Pre-Operational Stage--------------------------------------- Operational Stage


                                           Strategic and Program Planning
 Develop Governance

                                                         Recruit Human Resources


                                                 Develop Community Partnerships/ Local Integration


                                                            Determine Physical Location (s) & Logistics of Collaboration


                                                                                                           Service/Program Delivery




C6) Financial Forecast
Please refer to the Guide to Business and Operational Plan Development, section 4.3 and to
Operational Plan Funding Application Template, Schedule 1, to complete this section.

 REQUIREMENTS:
 • Provide a 5-year financial forecast.


SAMPLE TEMPLATE
Please see Schedule 1, Appendix E – Financial Forecast/Budget for a sample budget.
                                                                                                       Page 29

                                   C. Operational Plan
   The Operational Plan provides detail on the major activities, timelines and resource requirements
   for implementing each fiscal year of the Business Plan. The detailed annual plan allows for
   more precise planning of items outlined in the business plan and allows you to advise the
   Ministry of changes/updates in your Business Plan. It sets out detailed funding requirements for
   the coming Fiscal Year (April 1- March 31) for implementing that year of the Business Plan.



   D1) Core, Optional, and Special Services/Programs
   Enrolment
   Please refer to the Guide to Business and Operational Plan Development, section 5.1.2
   and 5.1.3; and to the Guide to Patient Enrolment as you complete this section.

    REQUIREMENTS:
    • Identify total population to be served
    • Identify the number of patients already enrolled
    • Describe plans for enrolling additional patients including the number and
      estimated timelines
    • Identify whether patients will be enrolled to individual physicians or to a group
      of physicians
    • Separately identify the number of new patients/clients to whom you anticipate
      providing services, and the number of new patients who did not previously have
      regular access to primary health care.



   SAMPLE TEMPLATE/RESPONSES

 Provider Current #                               Enrolment                                Previously
     Or    patients                                                                        unattached
   Group   enrolled   Yr 1            Yr 2         Yr 3        Yr 4            Yr 5        (orphaned)
Dr. A     500       750           1,000        1,250        1,500      2,000              1,500

Dr. B      X           X+Y1       X+Y1+Y2 X+Y1+Y2+ X+Y1+ X + Y1 + Y2 +                    # of new
                                          Y3       Y2 + Y3 + Y3 + Y4 + Y5                 patients
                                                   Y4                                     previously
                                                                                          unattached
                                                                                           Page 30

SAMPLE 2




Programs and Services
Please refer to the following guides to help you complete this section:
• Guide to Business and Operational Plan Development, section 5.1.3
• Guide to Chronic Disease Management and Prevention
• Guide to Health Promotion and Disease Prevention
• Guide to Collaborative Team Practice
• Guide to Community Funding Partnerships and Program/Service Integration
REQUIREMENTS:
• List the core/comprehensive care service that your Family Health Team will provide
• Include the following for each of the proposed core, optional and special
  services/programs requiring an interdisciplinary team:
      o The name of the proposed program or service
      o A brief description of the service/program including objectives and how it will
          address population needs, service gaps, and the proposed location of the
          program/service (e.g. Family Health Team practice site, partner organizations,
          community)
      o Identification of the provider(s) who will deliver the program/service (type and
          full-time equivalency). If more than one type of provider is involved, provide
          a brief description of their respective roles (If roles have already been
          discussed, refer to the relevant section of your plan).
      o A brief description of any linkages/partnerships (e.g., service coordination and
          collaboration initiatives) with other service delivery organizations and the
          role/services to be delivered by the other service delivery organization
      o A list of the services to be provided.
                                                                                                          Page 31

SAMPLE TEMPLATE

Identify key milestones and timelines for the “roll-out” of the services/program including
establishing linkages with other service delivery organizations.

Core Comprehensive Care          Description,         Provider   Linkages/            Key Milestones
Services (Mandatory)             Objectives, how      Type &     partnerships         and Timelines for
                                 program will         FTE.       with other service   Roll-outs
                                 address needs/gaps   Provider   delivery
                                                      Roles      organizations,
                                                                 service to be
                                                                 delivered
Health assessments
Diagnosis and treatment
Primary reproductive care
Primary mental health care
(early identification and
treatment of emotional and
psychiatric illnesses and
where appropriate collaborate
with psychiatrists or the FHT
mental health workers)
Primary palliative care
(provide palliative care or
provide support to the team
responsible for providing
palliative care)
Support for hospital, home,
public health and long-term
care facilities (through
formalized linkages, assist
with discharge planning,
rehabilitation services, out-
patient follow-up and home
care services)
Service coordination and
referral (coordination of
services among the FHT and,
where appropriate, referrals
to other health care providers
and agencies)
Patient education and
preventative care
Access to pre-natal,
obstetrical, post-natal
maternal care and in-hospital
newborn care
Arrangements for around-
the-clock care (through
extended office hours and the
THAS)
Chronic disease management
programs
Organized health promotion
and disease prevention
programs*
                                                                                                       Page 32

Optional Programs             Description,         Provider   Linkages/            Key Milestones
                              Objectives, how      Type &     partnerships         and Timelines for
                              program will         FTE.       with other service   Roll-outs
                              address needs/gaps   Provider   delivery
                                                   Roles      organizations,
                                                              service to be
                                                              delivered
X-ray, ultrasound, sleep
studies, pulmonary function
studies, nuclear medicine
(IHF-licensed Services)
Laboratory services
Some minor day surgery
Some specialist services
(e.g., internal medicine,
pediatrics and cardiology)

Other special programs/
services*
*For example, programs targeted to specific population needs.


SAMPLE RESPONSE (Chronic Disease Management)


                       CHRONIC RESPIRATORY DISEASES PROGRAM
Rationale:
    •
    •   Need to prevent onset of disease by reaching high risk individuals for development of
        COPD and Asthma as well as those already diagnosed
    •   Region identified as having a lower socioeconomic status, and therefore determined to be
        at high risk for development of chronic disease such as COPD
    •   Barriers such as access to specialized services, identified – e.g. transportation

Goals:
  • Improve access and compliance to specialized respiratory services
  • Improve quality of care

Objective(s)

    •   Timely and consistent identification and screening and accurate early diagnosis
    •   Timely access to primary care services i.e. during acute exacerbations
    •   Timely access to consultants
    •   Provide evidenced based care
    •   Adherence to evidence based guidelines
                                                                                                    Page 33

Approach:

   •   The current COPD program is a satellite of the TRIANGLE/GSK Program at ORS
       Hospital and provides early identification and screening for COPD through spirometry;
       patient education such as medication (use and administration), breathing techniques,
       exercise and diet, and exacerbation management.
   •   The current Asthma Education program is a satellite of the ORS Asthma Program and
       provides identification, screening and assessment for asthma; patient education such as
       medication use and administration, breathing techniques, exercise and diet and
       exacerbation management.
   •   All patients who attend either of these respiratory clinics will be targeted for smoking
       cessation programs.
   •   Both of these programs provide opportunities for inter-professional and multidisciplinary
       consultation, shared care and education.
   •   These programs provide improved access for patients of all ages to treatment and services
       to those with COPD and asthma.

Program Description:
   • outreach clinics 1 day per month interdisciplinary approach with a core team consisting
        of:
            o respiratory therapist
            o respiratory NP/Asthma Education Nurse
            o SL FHT Nurse Practitioner and Registered Nurse
            o Extended Respiratory Team: Respirology consultant;
            o FHT Family Physician
   • Early Identification, Screening and Assessment
The AB FHT NP works with therapists to implement change, and educates providers to become
more adherent to the standards of care. All providers, including residents and students rotate in
RT clinics. Increased compliance of providers to protocols will be passed on to more
compliance/education with patients.
A built-in recall system with track patients and notify for re-screening and assessment.


Program evaluation:
The following outcomes will be monitored and tracked
   • Improved adherence to current COPD and Asthma Consensus Guidelines
   • Decreased prevalence of smoking –monitor changes in smoking rates through IT
   • Action Plan of Care in chart for every asthma patient
   • Decrease in lost work days, school days, social activities
                                                                                                 Page 34

D2) Human Resources and Recruitment Plan
Please refer to the following guides to help you complete this section:
• Guide to Business and Operational Plan Development, section 5.1.4
• Guide to Physician Compensation
• Guide to Interdisciplinary Team Roles and Responsibilities
• Guide to Interdisciplinary Provider Compensation
• Guide to Collaborative Team Practice

Profile of Existing Practices


 REQUIREMENTS:
 • Please Specify:
       o The name and source of funding for each current primary care physician,
          specialist, interdisciplinary health care provider and/or administrative staff
          member (herein “members”).
       o The full time equivalency of current members. For the latter, please specify the
          funding source(s) for each – indicate if position is co-funded by two different
          sources.
       o Whether physicians currently do obstetrics, emergency work, coverage of
          nursing homes, inpatient coverage.
       o Which interdisciplinary provider position is dedicated to a specific program (e.g.
          Chronic Disease Management) and which provider will provide a range of
          primary care services
       o The number and type of interdisciplinary staff that have already received
          approval via an “Early Win”*.

   *Early Win is a stage in the development of Family Health Teams where proponents begin
   early implementation of their FHT in advance of the full Business Plan review and approval;
   certain criteria must be met.

Compensation

Refer to the Guide to Business and Operational Plan Development, section 5.1.4; the Guide to
Physician Compensation, and the Guide to Interdisciplinary Provider Compensation to help you
complete this subsection.

 REQUIREMENTS:
 • Specify the current compensation model for participating FHT physicians, specialists,
   interdisciplinary providers, and administrative staff.
 • Specify the compensation model that physicians in the FHT will choose.
 • Specify the compensation method (salary or contract), and amount for
   interdisciplinary providers and administrative staff.
                                                                                             Page 35

Proposed Staffing Plan

 REQUIREMENTS:
 • Please provide a detailed staffing plan that includes:
       o The number of additional physicians, specialists, providers and administrative
          staff requested
       o The qualifications, roles and responsibilities of each FHT member within
          programs and/or services you will be providing
       o The full-time equivalency of each requested position
       o Where FHT members will be located.
       o Whether physicians will be doing obstetrics, emergency work, coverage of
          nursing homes, inpatient coverage.
Recruitment Plan
       o Whether interdisciplinary provider positions will be dedicated to a specific
          program (e.g. Chronic Disease Management) and which ones will provide a
          range of health care services.




Proposed Recruitment Plan

 REQUIREMENTS:
 • Provide key milestones and timelines for implementing the staffing/recruitment plans in
   Appendix E.
 • Clearly differentiate between existing members, those already committed to working
   with the Family Health Team but not yet available, and those who need to be recruited.
   For those providers already committed, indicate approximate commencement date and
   attach a letter of commitment
 • Provide job descriptions, as per appendix A
SAMPLE TEMPLATE/RESPONSE                                                                                    Page 36

      Staff         Current     New         Total    Remuneration   Remuneration   Current     New Source   Program or     Recruitment   Location
                                FTE       Proposed     Method         Amount*      Source of   of Funding     Service
                                                                                   Funding
                      FTE                   FTE                                                                            C        R

Physician Personnel
                                                                                                                           C–
  Psychiatrist                 0.125       0.125       Sessional      $15,000                     FHT          MH        1/4/07           Site A
                                                                                                                           C–
Family physician       19                    19                                      FHG          FHN                    current          Site B
                                                                                                                           C–
Family physician       1                     1                                       FHG          FHN                    current          Site A
Interdisciplinary Health Care Providers
   Dietitian                    0.8         0.8        Contract       $66,960                     FHT         CDM                   R     Site A
     Nurse                                                                                                                 C–
  Practitioner                   3           3          Salary        $288,000     FHT - EW                  PC/CDM      current          Site B
                                                                      $214,920                                             C–
Registered Nurse       1         3           4          Salary        (for new)    VON City                    PC        1/2/06           Site B
Administrative
     FHT                                                                                                                                  Sites
 Administrator                  0.5         0.5         Salary        $28,800                     FHT                               R     A&B
  Receptionist                   3           3          Salary        $126,000                    FHT                               R     Site B


    TOTAL              21      10.43       31.43                      $739,680

* Remuneration Amount includes 20% benefits for providers paid by salary or contract.
CDM = Chronic Disease Management
FHT – EW = MOHLTC funding received under “Early Win” funding.
MH = Mental Health
PC = Primary Care
C = Committed and commencing on [Day/Month/Year].
R = Position needs to be recruited.
                                                                                              Page 37
SAMPLE RESPONSE

Timelines for Introduction of new FHT personnel
Month                                           FTE Position                      Stage
April 2006
Core Programs for ABC FHT                            0.5   Social Worker          Early win
                                                     1.0   Pharmacist             Early win
Chronic/Palliative/Home Care                        0.75   Nurse Practitioner     Early win
Adolescent                                           0.1   Social Worker          Early win
                                                     0.2   Nurse Practitioner     Early win
Diabetes                                             0.4   Social Worker          Early win
Women’s Health                                      0.05   Nurse Practitioner     Early win
Support                                              1.0   Clerk 1                Early win



May 2006
Administration                                       1.0   FHT Administrator      BPOP *
Core programs ABC FHT                                0.5   Dietitian              BPOP
                                                     2.1   Shared Mental Health   BPOP
                                                     0.6   Clerk                  BPOP
                                                     1.0   Registered Nurse       BPOP
Adolescent                                           0.1   Sessional Physician    BPOP
                                                     0.5   Registered Nurse       BPOP
                                                     0.1   Registered Nurse       BPOP
Shared Obstetrics                                    0.2   Registered Nurse       BPOP
Women’s Health                                      0.05   Registered Nurse       BPOP
Chronic/Palliative/Home Care                         0.5   Social Worker          BPOP



July 2006
Core programs Site #2                                0.5   Social Worker          BPOP
                                                     0.5   Pharmacist             BPOP
                                                     0.8   Nurse Practitioner     BPOP
                                                     3.5   Registered Nurse       BPOP
                                                     0.2   Dietitian              BPOP
                                                     4.5   Clerk 1                BPOP
                                                     0.5   Secretary 4            BPOP
                                                     2.1   Shared Mental Health   BPOP



September 2006
Primary Care                                         0.2   Registered Nurse       BPOP
                                                     0.2   Nurse Practitioner     BPOP
                                                     0.3   Social Worker          BPOP
                                                     0.2   Dietitian              BPOP
Child Health                                         0.1   Registered Nurse       BPOP
                                                     0.1   Nurse Practitioner     BPOP
                                                     0.1   Social Worker          BPOP

Total for 2006/2007                             24.45

BPOP – Business Plan and Operational Plan Request
                                                                                                 Page 38

D3) Collaborative Team Practice
Please refer to the following guides as you complete this section:
   • Guide to Business and Operational Plan Development, section 5.1.5
   • Guide to Collaborative Team Practice
   • Guide to Interdisciplinary Team Roles and Responsibilities

   REQUIREMENTS:
   • Identify how the collaborative team practice will contribute to achieving the Family
     Health Team objectives;
   • Demonstrate how the efficient and effective use of allied health professionals will allow
     more patients to be referred to appropriate providers, thereby freeing up physician time
     for new patients;
   • Identify and justify any training requirements to support collaborative care.




SAMPLE OF THE TYPE OF ISSUES TO BE ADDRESSED

How does collaboration occur in a Family Health Team?
   •   Day to day contacts – the basis of collaboration
   •   Clinical teams – the structures that support collaboration

How will the following characteristics of well functioning teams be
addressed?
   •   Clear goals and purpose
   •   Clear roles and responsibilities
   •   Clear and regular communication
   •   Mutual trust, respect, understanding and support
   •   Recognition and appreciation of contributions of all team members
   •   Effective leadership
   •   Mechanisms and strategies for team tasks
   •   Appropriate organizational structures including meetings

What barriers prevent effective team functioning?
Consider how to address barriers to Interdisciplinary Team Development such as:
   • ineffective leadership,
   • lack of clarity or disagreement about program goals or priorities
   • poor or inconsistent communication,
   • inter-professional differences or different agendas,
   • interpersonal conflicts,
   • competing organizational priorities,
                                                                                                     Page 39

   •   different conceptual approaches,
   •   a fear of change
   •   a reluctance to accept new team members
   •   a failure to work towards agreed upon goals or targets

Team Performance Checklist
The following is a checklist of factors a Family Health Team can use to assess its team performance
   • Goals
   • Roles
   • Communication
   • Processes for team tasks
   • Working Together
   • Leadership
   • Organizational structures / Meetings

Timeframe Required by Team to Become Fully Functional
Identify the timeframe that the FHT team will need to become fully functional and any major
milestones to be met.

Training Requirements to Support Collaborative Care
Provide a description and justification for any training requirements to support the collaborative
team approach and the provision of collaborative care i.e. training to address success factors and
team performance checklist factors.
                                                                                                 Page 40

D4) Physical Site Preparation
Please refer to the Guide to Business and Operational Plan Development, section 5.1.6, and to
the Guide to Transitional Funding to help you complete this section

   REQUIREMENTS:
   • Eligible FHT applicants requesting infrastructure funding for facility renovations are
     required to submit a Facility Plan that describes:
     Facility space requirements to accommodate the proposed FHT
             o Facility space requirements for each facility in the FHT (e.g. additional FTEs,
                 area, specific facility needs).
             o Applicants are required to complete the appropriate Facility Space Requirements
                 Template depending on the scope of renovations (e.g., existing facility or new
                 facility space)
             o Discussion of key assumptions used to determine facility space requirements
   • Proposed FHT Facility
             o Proposed facility layout – space allocation, size of space
             o Scope of renovations, including upgrades to building systems -mechanical,
                 electrical, architectural.
             o Confirmation by a qualified professional that all proposed changes are
                 technically feasible and comply with applicable codes, statutes and ordinances.
             o The proportion of the facility space required for co-located/additional
                 interdisciplinary staff and related support services.
             o Terms of proposed lease/rent. Identify facility ownership and if any are FHT
                 members, including board members.
             o Details of plans to share the proposed facility space with other providers or
                 organizations that are not part of the proposed FHT. Identify the affected facility
                 space area and cost sharing arrangements.
             o Renovations timeline.
   • Estimated renovation and related costs of the selected option.
             o Provide a high level breakdown of estimated renovation costs, similar to a Class
                 “D” order of magnitude budget including:
                     Planning and design costs (planners, architect, engineers)
                     Construction costs
             o Provide an estimate of proportion of estimated costs for the additional facility
                 space for co-locating practitioners. Please include an explanation of your
                 rationale for the estimate.
             o Source of funds:
                     Available or expected source of funds
                     A description of financial and/or in-kind support such as contributions form
                     sponsors, community partners or landlord that will be used to offset one-time
                     expenditures and any conditions attached to each contribution.
                     Confirm that where total renovation cost estimates exceed $10,000 the FHT
                     will use a competitive bidding process to obtain a minimum of three quotes
                     and provide a justification for the quote.
   • Please attach quotes, estimates for renovations and floor plans as required in Appendix B.
     section “Physical Site Preparation”.
                                                                                            Page 41

SAMPLE RESPONSES/TEMPLATES

SAMPLE 1: PROPOSED STAFF CHANGES

                                        Proposed Staff Changes
                                                Current         Proposed
                             Position           Staff           Staff           Change
                                                  FTEs             FTEs          FTEs
              Physicians                                   8               18       10
              Interdisciplinary Staff
               - Nurse Practitioners                       1               3            2
               - Registered Nurses                        0.5              4        3.5
               - social worker                             0              0.5       0.5
               - dietician                                 0          0.25         0.25
               - psychologist                              0               0
               - other

              Administration
               - receptionists                            1.5              3        1.5
               - manager/other personnel                  0.5             0.5           0
              Total                                   11.5           29.25        17.75
                                                                                                         Page 42

SAMPLE 2: ADDITIONAL REQUIREMENTS RELATED TO CO-LOCATION

                 Renovations to Existing Physician Location
              Additional Space Requirements Related to Co-location
Position/Function                             Rooms                   number       size in sq.ft
Physicians:
Physician 1                                   office                           1                   110
                                              examination room                 2                   180
Physician 2                                   office                           1                   110
                                              examination room                 2                   180
Physician 3                                   office                           1                   110
                                              examination room                 2                   180
Physician 4                                   office                           1                   110
                                              examination room                 2                   180
Physician 5                                   office                           1                   110
                                              examination room                 2                   180
Physician 6                                   office                           1                   110
                                              examination room                 2                   180
Physician 7                                   office                           1                   110
                                              examination room                 2                   180
Physician 8                                   office                           1                   110
                                              examination room                 2                   180
Allied Health Professionals
- nurse practitioner 1                        office                           1                   110
                                              examination room                 2                   180
- nurse practitioner 2                                                         1                   110
                                              examination room                 2                   180
- registered nurse                            office/clinical space            1                   125
- registered nurse                            office/clinical space            1                   125
- registered nurse                            office/clinical space            1                   125
- registered nurse                            office/clinical space            1                   125
- dietitician/social worker                   shared space                     1                   110
Common functions
- reception                                                                    1                    75
- administration                                                               1                   120
- storage                                                                      1                    50
- waiting area                                                                 1                   400
- meeting room                                                                 1                   200
- medical records                                                              1                   100
- public washroom                                                              2                   250
sub-total - net floor area                                                                     4705
Gross Floor Area (add xx% of net floor area                                                    TBD
Total additional space required                                                                TBD
                                                                                                                                                                    Page 43

SAMPLE 3: RENOVATIONS TO NEW FACILITY SPACE

                                            Proposed Facility Space Requirements - New Site
                                                                                          Estimated % of Use                               Space
                                      Function of                     Size in
Description of rooms/space                               Number                  existing          co-locating            existing           co-locating
                                     rooms/space                      sq. ft.
                                                                                 practitioners     practitioners          practitioners      practitioners
Physicians:
- Physician 1                    Office                           1        110               100%                     0                   110                  0
                                 Examination room                 2        180               100%                     0                   180                  0
- Physician 2                    Office                           1        110               100%                     0                   110                  0
                                 Examination room                 2        180               100%                     0                   180                  0
- Physician 3                    Office                           1        110                 0%                  100%                     0                110
                                 Examination room                 2        180                 0%                  100%                     0                180
- Physician 4                    Office                           1        110                 0%                  100%                     0                110
                                 Examination room                 2        180                 0%                  100%                     0                180
Interdisciplinary Staff
- Nurse Practitioner             Office                           1        110               100%                     0                   110                  0
                                 Examination room                 2        180               100%                     0                   180                  0
- Nurse Practitioner             office/clinical space            1       110                  0%                  100%                     0                110
                                 examination room                 2       180                  0%                  100%                     0                180
- Registered nurse               office/clinical space            1       125                    0                 100%                     0                125
Common functions
- reception                                                       1        75                 50%                  50%                    37.5               37.5
- administration                                                  1       120                 50%                  50%                     60                 60
- storage                                                         1        50                 50%                  50%                     25                 25
- waiting area                                                    1       400                 50%                  50%                    200                200
- meeting room                                                    1       200                 50%                  50%                    100                100
- medical records                                                 1       100                 50%                  50%                     50                 50
 - public washroom                                                2       250                  0%                  100%                     0                250
Sub -total - net space                                                                                                               1342.5             1717.5
Gross floor area - (add YY% to
                                                                                                                                          TBD                TBD
net space)

Total Space Requirements                                                                                                                  TBD                TBD
                                                                                                     Page 44

D5) Information Technology and Electronic Medical
     Records
Information Technology

Please refer to the Guide to Business and Operational Plan Development, section 5.1.7; and to
the Guide to Information Technology to help you complete this section.

 REQUIREMENTS:
 • Indicate whether IT funding has already been received
 • Indicate the relevant program/source of funding, as well as status of IT implementation.
 • If IT systems have not yet been implemented, indicate key milestones and anticipated
   timelines for implementing main components.
 • Specify the resources that you will seek from the Ministry and the providers/team
   members these IT resources will support (Note: the cost of physician IT is supported
   through the Ontario MD Program, formerly the Ministry’s E-physician project).


SAMPLE RESPONSE

Information technology will be a vital component in the successful implementation of the ABC
FHT. A primary goal of the FHT will be to establish a management information system which
enables the collection and sharing of patient information as well as the collection and reporting
of vital service utilization statistics. It is expected that the MIS will support the establishment of
a single electronic patient record and that this information will facilitate better service
planning/coordination amongst involved health providers.

Status of IT Implementation
To date, the FHT planning team has not implemented a particular IT strategy and has received no
dedicated funding to do so. However, the planning team has identified that the FHT will
establish a comprehensive MIS to support its work and that this system will be utilized by all
health providers and staff involved with the FHT. To this end, preliminary efforts have been
made to review other similar IT models already in place and to identify viable platforms and
technological infrastructure requirements to develop such a system in Espanola.

Anticipated Timelines for Implementation
The development of an effective MIS has been identified as a priority implementation objective
of the FHT. The planning team has identified that this information technology should be put in
place within the first year of operation to enable the FHT to collect and share vital patient and
service utilization data as well as monitor the effectiveness of the programs and services it
delivers. Consequently, it is expected that once the FHT is officially launched, a dedicated
working group will be established to oversee the planning and implementation of this MIS within
the first 6-9 months of operation. This planning and implementation work will include:
identifying the information system requirements of the FHT, conducting research on available IT
                                                                                                 Page 45

systems, identifying hardware, software and capital infrastructure requirements, identifying
training and orientation support and developing a work plan to support successful
implementation.

IT Resources for Team members
It is understood that the participating physicians will have access to IT funding and resources
through the Ontario MD program as part of the development of this MIS, but that all other
members of the interdisciplinary team will require funding to be included in this information
technology initiative. This funding will provide each member of the interdisciplinary team with
access to the requisite hardware/software infrastructure to enable them to record their individual
service delivery information and be linked to all members of the FHT. At a minimum, this will
include computers for each team member as well as relevant software and training support.

SAMPLE 2

System Overview:
ABC physicians and clinical support staff have used an integrated Electronic Medical Records
(EMR) since 1997. The program allows for rapid sharing of pertinent health information
between all health providers, appointment scheduling for all providers, and has a search tool that
will allow us to track various health care parameters and monitor the services provided by the
ABC FHT. The system that is currently used is one of the OntarioMD conformance–tested
systems and is current. Funding for physician IT has been secured from OntarioMD. IT
requirements being requested are for new interdisciplinary providers and one additional
administrative support person. Requirements are 7 desktop set-ups, 1 lap top and 3 printers in
addition to the equipment we currently have.
Implementation Plan:
All hardware and software and related equipment can be ordered immediately and the system can
be up and running within a month from the start-up of the FHT, e.g.

Month 1:
Week 1 - Order and receive equipment
Week 2 – Installation of hardware and software
       Week 3 – Training
       Week 4 – User Acceptance Testing
System Costing:
The total costs of the hardware and software will be $26,280 (includes applicable taxes). (See
Appendix 2 – Quote for hardware, software, etc.). Ongoing maintenance will be $2,200 plus
applicable taxes annually. We have allocated $2,000 annually for software upgrades.
                                                                         Page 46

Information Technology - (Extract from Year 1 Budget)
New Provider/Staff              Item       Cost Per Item*   Total Cost
Nurse Practitioner (2)          Desktop    $ 2,300          $ 4,600
Nurse (2)                       Desktop    $ 2,300          $ 4,600
Dietician (1)                   Desktop    $ 2,300          $ 2,300
Mental Health Worker (1)        Desktop    $ 2,300          $ 2,300
Pharmacist (1)                  Laptop     $ 1,500          $ 1,500
Admin Support (1)               Desktop    $ 2,300          $ 2,300
Shared equipment (3)            Printers   $ 1,150          $ 3,450
Installation (wiring, etc.)                $ 1,200          $ 1,200
Training (CMS)                             $ 1,500          $ 1,500
Year 1 pre-paid maintenance                $ 2,530          $ 2,530
Total Request                                               $ 26,280

*Includes applicable taxes
                                                                                                   Page 47

D6) Extended Hours/Telephone Health Advisory Service
(THAS)

Please refer to the Guide to Business and Operational Plan Development, Section 5.1.8; and to
the Guide to Telephone Health Advisory Service (THAS).

 REQUIREMENTS:
 • Please identify plans and anticipated timelines for implementing your extended
   clinic hours.
 • Please provide a plan of action which identifies plans and anticipated timelines
   for implementing THAS.



SAMPLE RESPONSE
The after-hours clinic is open and staffed by a physician between 5 p.m. and 8 p.m. Mondays
through Thursdays and for a minimum of 3 hours each weekend. At least one of those three
hours blocks of after hours coverage is on Sundays with the additional clinic time being offered
on Saturdays in response to patient need. A physician is on call to the Telephone Health
Advisory Service after regular business hours Monday to Friday and on week-ends.

D7) Other Programs
Please refer to the Guide to Business and Operational Plan Development, Section 5.1.9 to help
you complete this section.

 REQUIREMENTS:
 • Please identify key milestones and estimated timelines for implementing plans
   for any research, teaching or other programs not already discussed.


       SAMPLE RESPONSE:
       All of our physicians are currently involved in peer reviewed funded research projects
       through the JKL Brown Centre. Research themes will be focused on:
               • integrating new disciplines into the primary health care team, chronic illness
                   and patient self-care,
               • the transition from acute hospitalization to home and community based care,
               • service delivery to underserved and disadvantaged populations
               • the effectiveness of information technology in the FHT setting and
               • evaluation of our programs

       As the Business Plan is implemented, we will look at further opportunities for research
       projects and identify milestones and timelines.
                                                                                 Page 48

D8) Evaluation
Please refer to the following guides as you complete this section:
• Guide to Business and Operational Plan Development, section 5.1.10
• Guide to Collaborative Team Practice
• Guide to Interdisciplinary Team Roles and Responsibilities

 REQUIREMENTS:
 • Identify how the effectiveness of the Family Health Team will be assessed
 • Indicate how you achieve your goals and objectives
 • Map the goals and objectives to examples in Guide such as
         o Patient satisfaction
         o Provider satisfaction
         o Increased level of Collaborative Care
         o Better management of health conditions
         o Enhanced access to care
 • Identify some desired outcomes
 • Identify an overall evaluation process
 • If possible, identify some performance measures using a Table format
 • Address the following sections in the Guide to Collaborative Team Practice:
         o Signs that a team is not working well
         o Team Performance Checklist
                                                                                                                         Page 49

SAMPLE RESPONSE

The following example addresses in part the evaluation requirements on page 46; it identifies
goals and objectives and links them to performance measures:

GOALS                                    OBJECTIVES                                 PERFORMANCE
                                                                                    MEASURES
1.   Provide comprehensive primary       -Determine scope of primary care           - # of Patients Enrolled in Family
     health care services through an       services to be provided (care              Health Team
     inter-disciplinary team of            continuum)                               - Practitioner Case Load
     doctors, nurses, nurse              -Determine inter-disciplinary team         - # of Health Care Practitioners
     practitioners and other health        staffing requirements                      in area
     care professionals as determined    -Develop Job Descriptions & Hire Staff     - # of new health professional
     by local needs                      -Act as a training site for Nurse            trainees
                                         Practitioners and Medical Residents.
2.   Provide patients of Family          -Establish contract/partnership            - # of contacts with THAS
     Health Teams with expanded          arrangements with THAS                     - # of ABC Family Health Team
     access to primary care through      -Determine staffing schedule and             patients using THAS
     the Telephone Health Advisory       protocols for after hour care/support      - % of ABC Family Health Team
     Service (THAS) - extended                                                        patients using THAS
     hours of practice service                                                      - Patient satisfaction survey
                                                                                    -FHT staff satisfaction survey
3.   Provide system navigation and       -Identify all other care partners          - # of referrals by referral type
     care coordination – linking         -Develop linking protocols with other      - # of care coordination protocols
     patients to other parts of the      care partners                                completed
     health care system such as acute    -Train Family Health Team staff to
                                                                                    - data base established to monitor
     care, CCAC services, long-term        perform linking/ navigation function
                                                                                      follow up status of patients
     care, public health, mental         -Get information on other care partners
                                                                                      linking with other parts of the
     health, addictions and                to share with patients
                                                                                      health care system
     community programs and
     services                                                                       - # of formal service agreements
                                                                                    made
4.   Provide patient-centred care        -Involve patient in care decisions         - % of patients who state they are
     where the patient is a key          -Determine what type of information is       involved in care decisions
     member of the team and uses           needed to support informed decision      - % of patients who state they are
     information and support to make       making                                     taking responsibility for their
     informed decisions on how to        -Include patients in the development of      own care management
     manage his/her self-care needs        health promotion and treatment plans     - Improvements to the ABC area
                                                                                      population health over time
                                                                                    - Patient satisfaction survey
                                                                                    results
5.   Include diagnostic and outpatient   -Determine what non-core (support)         - Rate of overall Family Health
     services such as X-ray,               services are needed and at what level.     Team patient utilization by
     ultrasound, and minor surgery       -Establish formal linkages to services       service type
                                         as needed.                                 - Consumer satisfaction survey
                                         -Determine payment methods for these       results
                                         services.                                  - benchmark turn around times
                                                                                    for results
                                                                                                                             Page 50

GOALS                                      OBJECTIVES                                   PERFORMANCE
                                                                                        MEASURES
6.   Emphasize client level health         -Establish health promotion program          - Improvements in overall
     promotion, illness prevention,        -Set up a data system to track &               population health of ABC area
     early detection/diagnosis               evaluate illness prevention, health          residents
                                             promotion efforts.                         - # and % of Family Health Team
                                           -Involve all patients in this initiative.      patients involved in health
                                                                                          promotion program(s)
                                                                                        - Consumer satisfaction survey

7.   Serve as a central driving force      -Research best practices and apply           - # and % of Family Health Team
     for the development of new              findings for chronic disease                 patients involved in chronic
     comprehensive community                 management and self care programs            disease management and self
     based chronic disease                 -Educate patients on this direction            care programs
     management and self care              -Establish management targets and            - Consumer satisfaction survey
     programs                              track outcomes
                                                                                         - # of formal service agreements
8.   Link with other health care           -Establish linkages with other health        made
     organizations at the community        care organizations                           - Consumer satisfaction survey
     level and, in general, adapt to the   -On going assessment of the                  - Community Health Assessment
     needs of the specific community         community primary care needs                 Survey results
     through some form of                  -Board of Directors to develop a             - Consultant Evaluation (every 2
     participation at the governance         communication plan for the Family          years)
     level                                   Health Team.                               - Communication plan developed


9.   Use information technology as         - Determine & address technology             - % of Family Health Team staff
     the backbone of system                needs                                          using electronic patient health
     integration, linking patient          - Train staff to use patient health record     record
     records across different patient      - Link patient records across the health     - Turn around time for patient
     care settings giving providers        system.                                        tests /results
     timely and secure access to test      - Ensure that test results and other         - # of health care agencies linked
     results and other important data        patient information is shared and            with
                                             prepared in a timely manner.                 E health record
                                           - Improved health outcomes due to            - Improvements in overall
                                           earlier intervention                           population health of ABC area
                                                                                          residents

     10. Increase health care access       - Monitor service volumes/levels             - # and % of patients in these
     for hard to serve groups &            - Implement communication strategy             groups obtaining service from
     consumers without a family            - Track people accessing system                FHT
     Physician                             - Develop plans to increase access           - Consumer satisfaction survey
                                                                                        - Improvements in overall
                                                                                          population health of selected
                                                                                          groups
                                                                     BRUYÈRE FHT LOGIC MODEL
                                                                                                                                                                                                                                                                                                                                                         Sample #2


  GOAL: To provide excellence in patient care, resident and student education and academic scholarship, in a healthy, supportive, bilingual work environment, and in
                   the larger context of health in the community.
                                                                                            OUTPUTS:                       SHORT TERM                              LONG TERM
                            OBJECTIVES:                  ACTIVITIES:                                                                                               OUTCOMES (3-5 years)
  INPUTS:                                                                           •#Rostered patients                    OUTCOMES (1-3 years)
                            ENHANCED CARE                       •Patient visits; physicians, allied       •#Other patients
                            •To work together as a team and     health and focused clinics/programs       •#Patient population by language           •Increase in rostered patients
•Physicians                                                                                               •#Patient visits (by profession)           •Multilingual patient population              •Medical care that is based on
                            with partners to provide            •Creation of an environment/culture
•Allied Health                                                  of health and wellness                    •#Patient visits (by program/clinic)       •Increase in patient visits                   evidence based best practices
                            excellent comprehensive health



                                                                                                                                                                                                                                            LOGIC MODEL
•Support staff                                                  •Team building, communication and         •#Patient Groups run                       •Excellent medical care and allied
                            care to our patient population in                                                                                                                                      •Fewer emergency room visits for
                                                                staff support                             •High health care team satisfaction        health care based on evidence based
•Information services       a bilingual and supportive
                                                                                                          •Low staff turnover rate                   best practices                                clinic clients
                            environment                         •Medical record communication
                                                                                                                                                                                                                                                          ABC Health Service.

•University of Ottawa                                                                                     •#Community consultation meetings          •Increase in mutual understanding of          •One stop health care provided for
                            •To improve the health of the       through I/S
medical residents and       patient population                  •Co-ordination of care with               held                                       roles of team members and incidence           the majority of patients to the clinic
students                    •To equip patients who have         community agencies and specialists        •#Referrals to allied health               of collaboration; satisfied workers
                                                                                                                                                     •Fewer referrals to specialists
                                                                                                                                                                                                   •Informed patients
•Partnerships (e.g.         chronic illness with self care      •Consultation with community              •#Referrals to community agencies
                                                                                                          •#Referrals to specialists                 •Reduced incidence of emergency               •Patients who are confident about
Shared Mental Health,       skills to maintain optimal          services
                                                                •Evaluation of services                   •# Visits to emergency departments         room visits                                   managing their chronic illness
                            health in the community
CCAC )                                                                                                    •# Drug interaction problems               •Reduced incidence of drug                    •Lowered incidence of Preventable
•Community                                                                                                •# Evaluations of services and referrals   interaction problems
                                                                                                                                                     •Satisfactory audits and evaluation of
                                                                                                                                                                                                   medical conditions such as
consultation                                                    •Enrolment of new patients
                            EXPANDED CAPACITY                   •Preventative health activities (e.g                                                 services and referrals                        diabetes, cervical cancer in patient
•Ministry funding           •To improve access to primary                                              •# of new patients registered                                                               population
                                                                lifestyle counselling, immigrant
•Research funding           care                                                                       •Focused clinics - patients seen                 •Informed patients
                                                                vaccination)                                                                                                                       •Access and interdisciplinary care
                            •To provide services that lead                                             •Installation of I/S system that allows for      •Increased patient understanding of
                                                                •Education and support of patients
                            to the prevention of serious                                               tracking and measurement                         illness and maintenance
                                                                                                                                                                                                   for marginalized groups (e.g..
                                                                in self care of chronic illness e.g.
                            medical conditions and              optimal drug usage, diabetes clinic,   •#Preventative bonuses accrued                   •Increase in number of preventative        immigrant and adolescent health)
                            unnecessary visits to               cardiac care, mental health,           •#Patient Education sessions run and             procedures undertaken by patients          •Access and focused
                            emergency rooms                     community liaison)                     evaluated                                        •Increased allied health/physician         interdisciplinary care for seniors
                                                                •I/S tracking of preventative care     •#Preventative health clinics undertaken         collaboration
                                                                                                       •# Allied health/physician collaborations                                                   •Patient satisfaction
                                                                                                                                                        •Fewer medication complications
                                                                                                       •Increased drug compliance                                                                  •Medical teaching that is based on
                            INTERDISCIPLINARY                      •Teaching activities (medical       •# Patient preventative procedures                                                          evidence based best practices
                            TEACHING                               residents, students, nursing,                                                     •Excellent education, training and            •Medical residents and students
                            •To provide excellence in              allied health)                                                                    evaluation is provided for medical
                            education and training for             •Creation of a climate of             •Time and # medical residents taught                                                      who are comfortable working in a
                                                                                                                                                     residents, medical students and allied
                            medical residents, medical             teamwork in the provision of          •Time and # medical students taught         health trainees                               multi disciplinary team setting
                            students and allied health             healthcare                            •Time and # allied health taught            •Health professionals and trainees are        •Medical Resident and medical
                            trainees                               •Team development and                 •# of successful teaching evaluations       exposed to multidisciplinary model of         student satisfaction
                            •To provide ongoing                    continuing education activities       (University and learner)                    care and can articulate the contribution of
                            education and training to the          •Outreach to community                •Learner attendance at team meetings                                                      •Research that provides a better
                                                                                                                                                     team members in a multidisciplinary
                            health care team                       teaching sites                        • #Learner referrals to team members        setting, and develop ways of optimally        understanding of health care needs
                                                                                                         •#Team education sessions run               working together                              and best practices
                                                                   •Formulation of research              •#CME hours
                            RESEARCH
                                                                                                                                                                                                   •Satisfied workers and low turnover
                                                                   questions and applications for        •Outreach visits to community practices
                                                                                                                                                      •Increased understanding of                  rate
                            •To undertake scholarly                funding
                            investigation to provide                                                                                                  optimizing health and resources
                                                                   •Papers written                        •#Funding applications
                            empirical evidence to support                                                 •#Research presentations
                                                                   •Presentations concerning
                            decision making in Primary                                                    •#Research papers published or
                                                                   findings
                            Health Care                                                                   accepted for publication
                                                                   •Creation of a climate of
                                                                   questioning and evaluation
                                                                                                                                                                                                                                                          A logic model has been developed to identify key indicators of success in our objectives.


                                                                                                                                                                                                                                                          part of the continuous quality improvement model and balanced scorecard programs of the
                                                                                                                                                                                                                                                          will report to Governance, and the Ministry. Continuous review of these indicators will form
                                                                                                                                                                                                                                                          Measurement of these indicators will be gathered and reported to the FHT Administrator who
                                                                                                                                                                                                                                                                                                                                                                     Page 51
                                                                                              Page 52

D9) Consolidated Timelines
Please refer the Guide to Business and Operational Plan Development sections 4.2 and 5.2 to
help you complete this section.


 REQUIREMENTS:
 • Provide a chart that outlines the timelines to:
      o implement programs and services (core and optional);
      o implement extended hours of service;
      o implement the Telephone Health Advisory Service;
      o recruit FHT members, and
      o prepare locations (leasehold improvements/renovations).


Please see SAMPLE RESPONSE in Appendix D - Timelines.


D10) Annual Resource Requirements/Budget
Please use the Operational Plan Funding Application Template and refer to the Guide to
Business and Operational Plan Development section 5.3, to complete this section.

 REQUIREMENTS:
 • Please complete the Operational Plan Funding Application Template.
 • Using Appendix C, please specify the details of the one-time operational clinical/office
   equipment, furnishings and IT.
 • In a separate spreadsheet please specify the assumptions used in preparing your budget.
                                                                                                            Page 53

       SAMPLE RESPONSE FOR ANNUAL OPERATING COST ASSUMPTIONS


                                                              OPERATING COSTS PER ANNUM


                    Maintenance         Clinical          Telecommunications     Office     Rent             Software         Professional        TOTAL
                                        Supplies                                 Supplies                    Licenses         Development

Nurse                    1,500              2,500                 600                600        7000              800              1,000          14,000
Practitioner

Other
                          860                500                  150                200        4000              800               500            7,010
Interdisciplinary
Providers

                                                                         RATIONALE


                    Office              Clinical          Prorated cost of       Prorated   Rent is          Monthly cost     Estimated cost
                    maintenance is      supplies’         phone, fax, and        cost of    prorated to      of software      of courses and
                    prorated based on   consumption       internet based on      office     the space        license          related expenses
                    the space the       per annum is      usage: $50/month for   supplies   occupied by      subscriptions    per
                    health              more for          NPs, and $25/month     based on   the health       is $800 per      interdisciplinary
                    professional is     nurse             for other providers.   usage.     professional.    health           provider.
                    occupying.          practitioners                                                        professionals.
                                        due to the
                                        nature of their
                                        practice.
                                                                                                                 Page 54


                                  E. Quick Reference Sheet
REQUIREMENTS:
• Please complete the template below which covers the following information on
  your Family Health Team (FHT):
     o Population Characteristics
     o Human Resources
     o Governance Structure
     o Programs and Services and Service Coordination
     o Timelines
     o Funding
     o Location

SAMPLE TEMPLATE/RESPONSE
Family Health Team Characteristics                                            Information Required
Population Characteristics
# of Patients in the Catchment Area of the FHT (if                            10,000
known)
      Number of Current Patients (if applicable)                              3,500
      Number of Current Enrolled patients (if applicable)                     3,000
      Number of Patients Targeted                                             4,000
      Estimated Unattached Patients                                           500
Human Resources                                                               Type                Number
      Types and Number of Providers                                           Dietitian           1
Governance Structure
      Proposed governance structure                                           Provider-Based
Programs and Services and Service Coordination
      Confirm that you will be providing mandatory Core                       Yes/No
      Services*
      Other Services/Programs* - List other/optional                          Minor Day Surgery
      services that you will be providing
      Service Partnerships                                                    List service partnerships
Timelines
      Time to become fully operational                                        Target timeframe to become fully
                                                                              operational
Funding
      Funding Partnerships & Contribution                                     VON – 1,500,000/year
      One-time start-up budget                                                1,500,000
      Operational (HR and Overhead) Budget – Year 1                           850,000
      Total funding for multi-year business plan                              5,750,000
Location
      Location(s) - single or multiple                                        Specify number of locations
*Please refer to appendix B of the Guide to Business and Operational Plan Development
                                                                                                 Page 55

                                   F. Appendices

Appendix A – Job Descriptions
JOB DESCRIPTION – NURSE PRACTITIONER


MAIN DUTIES AND RESPONSIBILITIES
      •   Individual Patient Assessment - Health assessment, immunizations, ordering
          laboratory-screening tests, diagnosis, treating illnesses and follow-up, health
          promotion and disease prevention counselling.
      •   Provide Same Day/ Walk In services to Family Medicine Patients for acute episodic
          illnesses.
      •   Provide house calls and community outreach visits when appropriate.
      •   Liaison with physicians and other team members as required
      •   Record and document as required by the FHT
      •   Arrange physician consultation if illness or treatment is outside NP’s scope of
          practice.
      •   Specialist referrals and appointments in consultation with physician.
      •   Liaise with community agencies as required.
      •   Patient education; provide individual and group sessions to patients in the
          understanding and management of particular health issues
      •   Teaching: Family Medicine Residents, Medical and Nursing students.
      •   Teaching: Inter-professional Team Members where it would help them in their
          practice
      •   Research: Participate in on-going research related to client groups of the FHT
      •   Provide clinic level leadership for education of nurses.
      •    “Seamless Care” Activities – Provide communication to hospital and community
          staff and other inter-professional team members as required to ensure smooth
          transition for care between care sites.
      •   Participate in the development and evaluation of policies, protocols and procedures
      •   Other Activities – Other activities may be assigned in collaboration with the inter-
          professional team

SKILLS, KNOWLEDGE REQUIREMENTS

  •   Excellent oral / written skills.
  •   Strong clinical skills.
  •   Flexible.
  •   Autonomous
  •   Ability to work effectively with all members of the health care team.
  •   Ability to work in an inter-professional team environment.
                                                                                              Page 56

   •   Ability to prioritize, manage time effectively and be flexible in a very active work
       environment.

Computer skills
Competency in computer based programs (Microsoft Programs -Access, Word, and Excel)

Bilingualism
Not required but would be an asset

EDUCATION AND SPECIFIC JOB REQUIREMENTS

   •   Baccalaureate Degree in Nursing
   •   Registered Nurse Extended Class (EC)
   •   Primary Health Care Nurse Practitioner Certificate.
   •   Masters Degree will be considered an asset.
   •   Current membership with the College of Nurses of Ontario.
   •   Current membership in professional associations, RNAO, NPAO

RELEVANT EXPERIENCE
Two-Three (2-3) years’ clinical experience as a Nurse Practitioner
Teaching experience will be considered an asset.

REPORTING STRUCTURE
The nurse practitioner reports to the FHT Manager for day to day operations. Professional
guidance and support will be provided by the Director of Nursing at XYZ Hospital.

JOB SPECIFICATIONS
  • These positions will be located at three sites of the ABC Family Health Team: The ABC
     site at the ABC Health Centre, DEF site at the Hospital and the XXX Clinic located at the
     XYZ Services Bureau on GHI Street.

   •   Hours of work (37.5 hours per week) will generally correspond to the FHT practice
       operations but may vary.
                                                                                                   Page 57

JOB DESCRIPTION – SOCIAL WORKER


MAIN DUTIES AND RESPONSIBILITIES


      •   Provide social assessment of clinic patients
      •   Provide counselling services, with particular regard to individual and family issues
          and decisions that impact the health of the patient and family
      •   Identify and support access to community, volunteer and professional services and
          programs appropriate to the care needs of the patient
      •   Assist the referring physician with referrals to secondary and tertiary health care
          centres
      •   Act as an advocate for patients and their families in matters affecting health
      •   Provide house calls and community outreach visits when appropriate.
      •   Liaise with physicians and other team members as required
      •   Liaise with other care providers in the health care system and community as required
      •   Provide patient education, and individual and group sessions to patients in the
          understanding and living with particular health issues
      •   Teach family medicine residents, medical and allied health students on the role of the
          social worker and psycho-social issues facing patients and families.
      •   Teach inter-professional team members
      •   Participate in on-going research related to client groups of the FHT
      •   Provide communication to hospital and community staff and other inter-professional
          team members as required to ensure smooth transition for care between care sites.
      •   Provide other Activities – Other activities may be assigned in collaboration with the
          inter-professional team

SKILLS, KNOWLEDGE REQUIREMENTS

  •   Excellent oral / written skills.
  •   Strong clinical skills.
  •   In depth knowledge of chronic illness care, including both clinical and supportive care
  •   In depth knowledge of the local health program delivery and community based services
  •   Ability to develop and maintain networks at the local and provincial level
  •   Ability to assess human bio-psychosocial responses
  •   Able to be innovative and creative in order to develop strategies that successfully meet
      the needs of diverse patient, family, and provider population
  •   Flexible.
  •   Autonomous
  •   Ability to work effectively with all members of the health care team.
  •   Ability to work in an inter-professional team environment.
  •   Ability to prioritize, manage time effectively and be flexible in a very active work
      environment.
                                                                                                   Page 58

Computer skills
Competency in computer based programs (Microsoft Programs -Access, Word, and Excel)

Bilingualism
Not required but would be an asset

EDUCATION AND SPECIFIC JOB REQUIREMENTS

   •   Baccalaureate Degree
   •   Masters Degree will be considered an asset.
   •   Registered or eligible for registration with the appropriate professional association

RELEVANT EXPERIENCE
  • Minimum of 5 years experience as a Social Worker with patients and families in a health
    setting
  • Demonstrated competence in team building, conflict management, and interpersonal
    effectiveness
  • Teaching experience will be considered an asset.

REPORTING STRUCTURE
The Social Worker reports to the FHT Manager for day to day operations. Professional guidance
and support will be provided by the Professional Leader for Social Work at ABC Health Service.

JOB SPECIFICATIONS

   •   This position will be located at The A site at the ABC Health Centre, the DEF site at the
       Hospital and the XXX Clinic located at the XYZ Services Bureau site on GHI Street. The
       position requires a valid drivers licence and access to a vehicle for home visits.

   •   Hours of work (37.5 hours per week) will generally correspond to the FHT practice
       operations but may vary.
                                                                                                  Page 59

FHT Administrator

JOB DESCRIPTION


Under the direction of the Executive Board, oversee the operations of the ABC Family Health
Team

MAIN DUTIES AND RESPONSIBILITIES

   •   Act as Secretary to the FHT Executive Board

   •   In conjunction with the Executive Board, establish Mission, Goals and Objectives and
       Operational and Business Plans.

   •   Provide the Board with information and recommendations concerning:
          o Mission, goals and objectives
          o Budget and financial management
          o Communication
          o Accountability
          o Dispute resolution
          o Risk management
          o Partner relations
          o Community relations
          o Patient relations

   •   Provide all required financial, statistical and management reports of the ABC FHT to the
       Ministry of Health and Long-Term Care

   •   Liaise with Partners

   •   Responsible for Material Resource Management

   •   Responsible for Human Resource Management

   •   Supervise Site Managers

   •   Evaluate program objectives
                                                                                              Page 60

SKILLS, KNOWLEDGE REQUIREMENTS

   •   Management skills
   •   Organizational skills
   •   Excellent oral / written skills
   •   Flexible
   •   Autonomous
   •   Ability to work effectively with all members of the health care team and partners.
   •   Ability to work in an inter-professional team environment.
   •   Ability to prioritize, manage time effectively and be flexible in a very active work
       environment.

Computer skills
Competency in computer based programs (Microsoft Programs -Access, Word, and Excel)

Bilingualism
English required. French not required but would be an asset

EDUCATION AND SPECIFIC JOB REQUIREMENTS
An accredited Master’s degree in Administration or an equivalent combination of relevant
education with a minimum of 5 years administrative experience
RELEVANT EXPERIENCE

   •   Management in a health care setting
   •   Financial management
   •   Successful work history of team work

REPORTING STRUCTURE
The FHT Manager reports to the Executive Board.

JOB SPECIFICATIONS
  • Hours of work (37.5 hours per week) will generally correspond to the FHT practice
     operations but may vary.
                                                                                            Page 61



Appendix B – Locations Details
Please attach quotes, estimates for renovations and floor plans as required under section
“Physical Site Preparation”.
                                                                                           Page 62

   Appendix C – Transitional One-Time Cost Details
Item                IP*     Quantity     Price Per Unit Price        Supplier       Model
Infant Scales       3 NPs   3                     200.00    600.00   ABC Supplies   123-456789
Exam Table          3 NPs   3                   1,600.00   4800.00   ABC Supplies   123-456781
Exam Stool          3 NPs   3                     350.00   1050.00   ABC Supplies   123-456782
Exam Light          3 NPs   3                   1,000.00   3000.00   ABC Supplies   123-456783
Ophthalmoscope/             3                                        ABC Supplies   123-456784
Exam Set            3 NPs                      1,000.00     3000.00
Baby Scale          3 NPs 3                    2,000.00     6000.00 ABC Supplies 123-456785
Adult Scale         3 NPs 3                      500.00    1,500.00 ABC Supplies 123-456786
Subtotal                                                  19,950.00
Applicable Taxes                                           2,992.50
TOTAL                                                     22,942.50

   *IP = Interdisciplinary Provider(s)
                                                                                           Page 63


                                               APPENDIX D – TIMELINES

                                           OPERATIONAL PLAN CHART
                                           Year 1 - April 1, 2006 – March 31, 2007
Task/Objective                             Apr May June July Aug Sept                Oct    Nov      Dec   Jan   Feb   Mar
Bring in Physicians                                       1                          3

Hire RNs                                                 1

Hire Nurse Practitioner                    2             1

Hire Social Workers                                      2

Hire/Contract Technology Support           1

Hire Nutritionist                                                             1
Hire Pharmacist (1/2 time)                                                    .5
Open Temporary Clinic Space G
(Main Street location)
Renovate and equip 2nd floor Fasano Bldg
(Clinic Space G & H)
Open Permanent Clinic Space H
(Fasano Building)
Provide office space for PH Nurse and
CCAC Case Worker
Develop and distribute patient brochure

Analyze Physician Compensation Options

Update of rolling 5 year business plan
                                                                                            Page 64

                                         APPENDIX D - OPERATIONAL PLAN CHART


                                            Year 2 - April 1, 2007 – March 31, 2008

Task/Objective                              Apr   May    June   July   Aug    Sept    Oct    Nov      Dec   Jan   Feb   Mar
Bring in Physicians                                                           3

Hire RNs                                                                       1

Hire Nurse Practitioner                                                        1

Hire Social Workers                                                            ½

Renovate and equip Gore Bldg basement
(Clinic Space I & J)
 Open Clinic Space I

Determine future physician compensation                                        .
model
Negotiate physician compensation

Establish teaching satellites

Update of rolling 5 year business plan
                                                                                              Page 65

                                           APPENDIX D - OPERATIONAL PLAN CHART

                                              Year 3 - April 1, 2008 – March 31, 2009

Task/Objective                                Apr   May    June   July   Aug    Sept    Oct    Nov      Dec   Jan   Feb   Mar
Bring in Physicians                                 2

Hire Pharmacist                                      ½

Open Clinic Space J

Examine potential for Satellite Clinics                                          .

Discuss partnership opportunities with T
Reserve
Examine other partnership options

Update of rolling 5 year business plan
                                                                                              Page 66

                                         APPENDIX D - OPERATIONAL PLAN CHART

                                              Year 4 - April 1, 2009 – March 31, 2010

Task/Objective                                Apr   May    June   July   Aug    Sept    Oct    Nov      Dec   Jan   Feb   Mar
 Examine and pursue partnerships in an                                          .
expanded geographic area

 Publish results of clinic model and
professional mix evaluations
Develop 10 year capital plan for ABC FHT

Seek approvals and funding for capital plan

Update of rolling 5 year business plan
                                                                                            Page 67

                                         APPENDIX D - OPERATIONAL PLAN CHART


                                            Year 5 - April 1, 2010 – March 31, 2011

Task/Objective                              Apr   May    June   July   Aug    Sept    Oct    Nov      Dec   Jan   Feb   Mar
Expand geographic catchment area through                                      .
partnerships

 Publish results of clinic model and
professional mix evaluations
Implement 10 year capital plan for ABC
FHT
Update of rolling 5 year business plan
                                                                                                                  Page 68


                                APPENDIX E – FINANCIAL FORECAST/BUDGET
                                    Funding Application Template: Business Plan
                                             5 Year Financial Forecast
                                    FUNDING REQUESTED FROM MINISTRY

Schedule 1: Business Plan                     Year 1             Year 2            Year 3            Year 4            Year 5

                                             1-Apr-06          1-Apr-07          1-Apr-08           1-Apr-09          1-Apr-10
                                                To                To                To                 To                To
                                            31-Mar-07         31-Mar-08         31-Mar-09          31-Mar-10         31-Mar-11
Human Resources                                $518,684          $739,934        $1,672,618         $1,722,797        $1,774,481

Other Overhead Costs                                 $211         $263,520          $271,426          $279,568          $287,955

Sub Total Operating                            $518,895        $1,003,454         $1,944,044        $2,002,365        $2,062,436

Start Up/One-Time Costs                          $24,469          $253,378                  $0                $0                $0

Total Costs                                    $543,364        $1,256,832         $1,944,044        $2,002,365        $2,062,436

Year 1 - Human Resources and Other Overhead Costs should be pro-rated to reflect actual time period of funding.
FHT Development grant show as year 1 start-up cost
                                                                                                   Page 69

                                                     Ministry of Health and Long-Term Care
                                                               Family Health Team
                                                 Funding Application Template: Operational Plan
                                                                  For the Period
                                                       April 1, 2006 date to March 31, 2007

                                                                                  (1)        (2)             (3)             (4)
Schedule 2 - Operational Plan (Summary)                                                      Ministry        Community       Other
                                                                                  Total      Funding         Partner         Sources of
                                                                                  Costs      Request         Contributions   Funding
                                                                                  (2+3+4)    "M"             "C"             "O"
Human Resources                                                    [Schedule 2]   $1,347,703 $739,934                        $607,769

Other Overhead Costs                                               [Schedule 3]   $856,848   $263,520                        $593,328

Sub Total Operating                                                               $2,204,551 $1,003,454 $0                   $1,201,097

One-Time Start Up Costs                                            [Schedule 4]   $737,618   $253,378                        $484,240

Total Costs                                                                       $2,942,169 $1,256,832 $0                   $1,685,337

Funding Component Legend:
"M" = Funding components requested from Ministry
"C" = Funding components provided by community partner contributions
"O" = Funding components provided by other sources
Column 1 - Total Financial requirements for the fiscal period
Column 2 - Net request from Ministry (Col. 1 - (Col. 3 + Col. 4)
Column 3 - Municipality, Hospital, CCAC, Private, etc.
Column 4 - current MOHLTC, other provincial or federal funding
                                                                                                     Page 70

                                                          SAMPLE TEMPLATE
                                                            Family Health Team
                                               Funding Application Template: Operational Plan
                                                                For the Period
                                                       April 1, 2006 to March 31, 2007
Schedule 3 - Operational Plan (Human
Resources)                                                                                                           (3)
Professional and Other Staff                         Maximum                                                                         (4) Other
                                       Position                                                       (2) Ministry   Community
                                                     Annual       Method of        (1) Total Costs                                   Sources of
                                       Complement                                                     Funding        Partner
                                                     Salary Per   Remuneration 3   (2+3+4)                                           Funding
                                       (FTE) 1                                                        Request "M"    Contributions
                                                     FTE 2                                                                           "O"
                                                                                                                     "C"



Non-Physician Personnel: 3
Registered Nurses – Extended Class
(Nurse Practitioners)

Jane Smith                             1.000         $80,000      Salary           $80,000                                           $80,000 5 6
                                                     $80,000      Salary
Sally White                            0.800                                       $64,000                                           $64,0005 6
New Position (Sally White)             0.200         $80,000      Salary           $16,000            $16,000

New Position (Annie Hall)              1.000         $80,000      Salary           $78,000            $78,000

New Position                           1.000         $80,000      Salary           $78,000            $78,000

Registered Nurses

Hilda Schmidt                          1.000         $59,700                       $59,700                                           $59,7005 6
New Position                           1.000         $59,700      Salary           $59,700            $59,700
                                                                                                    Page 71

Schedule 3 - Operational Plan (Human                                                                                (3)
                                                    Maximum                                                                         (4) Other
Resources)                             Position                                                      (2) Ministry   Community
                                                    Annual       Method of        (1) Total Costs                                   Sources of
Professional and Other Staff           Complement                                                    Funding        Partner
                                                    Salary Per   Remuneration 3   (2+3+4)                                           Funding
                                       (FTE) 1                                                       Request "M"    Contributions
                                                    FTE 2                                                                           "O"
                                                                                                                    "C"

Registered Practical Nurses
Susan Park                             1.000        $42,200      Salary           $42,200                                           $42,2005 6
New Position                           1.000        $42,200      Salary           $42,200            $42,200
New Position                           1.000        $42,200      Salary           $42,200            $42,200

Social Workers
Gordon Watts                           1.000        $66,000      Salary           $62,786                                           $62,7865 6
New Position                           1.000        $66,000      Salary           $62,786            $62,786

Dietitian
New Position                           1.000        55,800       Salary           $55,800            $55,800

Pharmacists
June Mitchell                          0.213        85,000       Salary           $18,077                                           $18,0775 6
New Position                           1.000        85,000       Salary           $85,000                                            $85,0005 6

FHT Program Coordinators
Lynda Black                            0.700        $48,000      Salary            $36,600                                          $36,600
New Position                           0.300        $48,000      Salary           $14,400            $14,400
                                                                                                                                    Page 72

Schedule 3 - Operational Plan (Human                                                                                                                     (3)
                                                                         Maximum                                                                                         (4) Other
Resources)                                           Position                                                                        (2) Ministry        Community
                                                                         Annual            Method of              (1) Total Costs                                        Sources of
Professional and Other Staff                         Complement                                                                      Funding             Partner
                                                                         Salary Per        Remuneration 3         (2+3+4)                                                Funding
                                                     (FTE) 1                                                                         Request "M"         Contributions
                                                                         FTE 2                                                                                           "O"
                                                                                                                                                         "C"

Psychiatrists

Ronald Gray                                          0.100               n/a                Sessional             $15,000                                                $15,000
                                                                                            Sessional
James Mitchell                                       0.100               n/a                                      $15,000                                                $15,000
Mary Petersen                                        0.025               n/a                Sessional
New Position                                         0.200               n/a                Sessional             $32,220            $32,220
Sub Total                                            13.638                                                       $959,669           $481,306                            $478,363
Benefits @ 20%                                                                                                    $191,934           $96,261                             $95,673
Total                                                                                                             $1,151,603         $577,567                            $574,036

    1
        Position Complement determined on basis of 37.5 hours per week per collective agreements
2
    Maximum Annual Salary per FTE - refer to Appendix A, "Salary Benchmarks for Interdisciplinary Health Care Providers" in the Guide to Interdisciplinary Comp
3
    Non-Physician Personnel - health care providers other than Physicians plus management and administrative staff
4   Physician Personnel - complete this section only if physician providers are to be remunerated on a salaried basis
5
    Current budget includes hospital, operating budget, University operating budget, clinical practice plan which captures PCN and fee for service revenues,
MOHLTC ISP Primary Health Care Program, and Student Program
6
    PHCP funds 1.85 FTE RN(EC)s, 2.4 FTE social workers and 0.7 FTE Program Coordinator
Funding Component Legend:
"O" = Funding components provided by other sources
                                                                                         Page 73

                                          Ministry of Health and Long-Term Care
                                                    Family Health Team
                                      Funding Application Template: Operational Plan
                                                       For the Period
                                              April 1, 2006 to March 31, 2007

Schedule 4 - Operational Plan (Other Overhead Costs)       2006/07            Ministry       Community     Other
                                                           Total              Funding        Partner       Sources of
                                                           Costs              Request        Contributions Funding
                                                           (2+3+4)            "M"            "C"           "O"
                        1
Equipment Lease(s)                                         $0                                              $0
Equipment Service Contract(s) 1                            $217                                            $217
Legal Fees                                                 $5,150                                          $5,150
Audit Fees                                                 $4,031                                          $4,031
Liability Insurance 2                                      $25,000            $25,000                      $0
Maintenance of Premises 3                                  $73,561                                         $73,561
Medical Supplies                                           $42,216                                         $42,216
Office Supplies                                            $45,846                                         $45,846
Staff Training and Development                             $4,176                                          $4,176
Rent - Site 1 and Site 2                                   $200,000           $200,000                     $0
           4
Telephone                                                  $24,029                                         $24,029
Travel / Parking / Meeting Expense                         $3,972                                          $3,972
Office Furniture (annual replacement budget)               $11,155                                         $11,155
Computer equipment repairs, software upgrades, supplies    $25,987            $5,400                       $20,587
Software subscription fee                                  $92,318            $33,120                      $59,198
Network connection fee ($300 per new user)                 $5,760                                          $5,760
Equipment repair                                           $1,595                                          $1,595
                                                                                                                       Page 74

Schedule 4 - Operational Plan (Other Overhead Costs)                            2006/07                     Ministry          Community        Other
                                                                                Total                       Funding           Partner          Sources of
                                                                                Costs                       Request           Contributions    Funding
                                                                                (2+3+4)                     "M"               "C"              "O"
Rent - Offsite facilities (XYZ Street)                                          $291,833                                                       $291,833

Total Other Overhead Costs                                                      $856,848                    $263,520          $0               $593,328

1
    Equipment Lease and Service Contracts - please submit separate detailed listing in support of total annual cost. (Fax machine at Site 1)
2
    Insurance - do not include professional liability insurance premiums
3
    Includes electricity, heat, security, renovations, housekeeping, and building maintenance
4
    Includes telephone equipment, long distance, Bell mobility pagers, fax lines and ISDN computer line
                                                                                       Page 75

                                              Ministry of Health and Long-Term Care
                                                        Family Health Team
                                          Funding Application Template: Operational Plan
                                                      Start-up/One-Time Costs
                                                           For the Period
                                                April 1, 2006 to March 31, 2007
                                                                           (1)             (2)            (3)          (4)
Schedule 5 - Operational Plan (Start                                                  Ministry       Community        Other
Up/One-Time Costs)                                                                                                   Sources
                                                                         Total        Funding          Partner         of
                                                 Price        Qty        Costs        Request        Contributions   Funding
                                                                         (2+3+4)       "M"               "C"          "O"
                    1
Clinical Equipment:
Exam Table                                           1,600       15          24,000         24,000
Exam Stool                                             350       15           5,250          5,250
Exam Light                                           1,000       15          15,000         15,000
Ophthalmoscope/Exam Set                              1,000       15          15,000         15,000
Baby Scale                                           2,000       17          34,000         34,000
Adult Scale                                            500       17           8,500          8,500
Patient Chair                                          200       21           4,200          4,200
Task Chair                                             350       15           5,250          5,250

Administrative Equipment/Furnishings
Computer workstation, chair and file cabinet
2
                                                    $2,660       25        $66,499         $66,499
                                                                                                              Page 76

                                                                                                                                              (4)
Schedule 5 - Operational Plan (Start
                                                                                                                  (2)            (3)         Other
Up/One-Time Costs)
                                                                                              (1)           Ministry         Community      Sources
                                                                                            Total           Funding           Partner         of
                                                              Price          Qty            Costs           Request         Contributions   Funding
                                                                                            (2+3+4)          "M"                "C"          "O"
Leasehold Improvements/Renovations
Site 1 renovations to multi-disciplinary team
room for expanded capacity                                                                   $138,190                                       $138,190
Site 2 expansion by 2,800 net square feet                                                    $110,050                                       $110,050
Relocation of FHT X                                                                          $236,000                                       $236,000

Other (please describe)
                                        2
Computer equipment and printer                                     $2,577         25          $64,429             $64,429
                                        2
Phone handset connection charge                                       $450        25          $11,250             $11,250

Total Start Up/One-Time Costs                              [to Schedule 1]                   $737,618         $253,378 $                    $484,240

1
 Clinical equipment - provide a separate listing of requirements by
provider type, e.g. Nurse Practitioner
2
    Workstations, computers and telephone equipment by provider: MD = 6, RN = 4, RPN = 2, SW = 2, Dietician = 2


Funding Component Legend:
"M" = Funding components requested from Ministry
"C" = Funding components provided by community partner contributions
"O" = Funding components provided by other sources
                                                                                                  Page 77


                              G. Acknowledgements
Samples used in the Business Plan Template were drawn from Business and Operational Plans
that were submitted for review. The Ministry is appreciative to the following Teams for sharing
their plans to assist others in moving forward with their own:

   •   Bruyère Family Health Team
   •   Centre For Family Medicine
   •   Espanola and Area Family Health Team
   •   Grandview Family Health Team
   •   Haliburton Highlands Family Health Team
   •   Leamington Area Family Health Team
   •   Marathon Family Health Team
   •   McMaster Family Health Team
   •   Queen’s Family Health Team
   •   Sharbot Lake Family Health Team
                                                                                             Page 78

                    H. Where to Get More Information
All potential Family Health Teams are assigned a Ministry FHT coordinator. This Ministry
contact person will be your guide to assist you to work through the details and options of
establishing a FHT. Please forward any comments on or suggestions for improvement to the
attached Template to your FHT coordinator.

If you have not yet been assigned a coordinator, please contact the Ministry at:

E-mail:FHTinquiry@moh.gov.on.ca
Address:      Primary Health Care Team
              Ministry of Health and Long-Term Care
              1075 Bay Street, 9th Floor
              Toronto, ON M5S 2B1
Telephone: 416-212-6155
Toll Free Phone:     1-866-766-0266

For more information on Family Health Teams in general, please refer to the Family Health
Team Fact Sheets or the Ministry of Health and Long-Term Care website at:
http://www.health.gov.on.ca/transformation/fht/fht_mn.html

								
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