Ontario Health Teams and Governance

Where are we in the OHT application process?

With the deadline to submit self-assessments now passed, the next phase in the Ontario Health Team (OHT) process is the selection by the Ministry of Health (Ministry) of groups of healthcare providers and organizations to submit full OHT applications.

Per the Ministry’s website, invitations to submit full OHT applications are expected to occur early July (extended from early June), with a subsequent deadline to submit the full application in September 2019.  The Ministry has said in its Guidance Materials that the full OHT application form will be provided to those groups selected for this next stage of the OHT process.

If invited to move forward to the full application stage, the organizations and providers (who will form the OHT) will be expected to demonstrate their ability to meet the readiness criteria identified by the Ministry in the Guidance Materials. One criterion is a commitment amongst the group of organizations and providers to formalize relationships for the proposed OHT’s structure and governance model. The Ministry has indicated in the Guidance Materials that:

providers that form Ontario Health Teams will be free to determine the governance model that works best for them, their patients, and their communities. Regardless of what governance model an Ontario Health Team adopts, it must be conducive to coordinated care delivery for patients, support achievement of performance targets, and enable the achievement of accountability objectives.

Governance is critical

The Ministry has also indicated that, at maturity, OHTs will receive an integrated funding envelope, and OHTs will be expected, as part of their governance structure, to demonstrate their ability to manage and oversee the integrated funding envelope. It will therefore be a critical exercise for the organizations and providers forming the OHT to determine how the OHT will be governed, as this governance model will have an impact on the distribution of the funding envelope amongst the members of the OHT.

FHT Boards need to consider …

For smaller organizations such as FHTs, it will be imperative that their Boards of Directors fully understand the implications of joining an OHT from a governance perspective. For example, FHT Boards should consider the following questions:

  1. Will one member of the OHT become a leader or designated paymaster for the integrated funding envelope? If so, how will this leader/paymaster be determined (e.g., will the choice be dictated by size and influence of the member organization?)

  2. How will a unified governance structure for the OHT impact the FHT’s ability to self-govern? For example, certain structures such as amalgamations and shared boards would remove the ability of the FHT to self-govern entirely.

  3. How will FHTs ensure that they are adequately represented in the governance structure selected for the OHT? The healthcare organizations and providers expected to form the OHTs will likely differ in size, the type of care provided, and patients cared for. It will be important for these organizations and providers to maintain their voice within the greater OHT structure.

Setting priorities

Before FHTs go down the path of submitting a full OHT application package and deciding (along with other members of the OHT) on a structure and governance model for the OHT, it is a worthwhile exercise for FHT Boards of Directors to:

  1. identify priorities for the FHT

  2. come to the OHT table with a plan to ensure that these priorities will not be lost or overshadowed in the greater OHT structure.

How we can help

DDO has provided advice to many FHT Boards of Directors on governance and can assist Boards in understanding how different structures and governance models will impact their ability to lead and govern the FHT once it is a part of the OHT.

For more information, please contact mdeiana@ddohealthlaw.com.

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