Lough Barnes Consulting Group (LBCG) presentation for CMHO on Collaborative Governance models for child and youth mental health organizations

1. Collaborative Governance:
A Model for Service System Integration
Bob Morton, Chairperson, North Simcoe Muskoka LHIN
Glen Newby, CEO, New Path Youth and Family Services
Steve Lough, Lough Barnes Consulting Group

2.  The context for collaborative governance in human services
 The collaborative governance model in the North Simcoe Muskoka LHIN
 Collaborative governance in Simcoe Child and Youth Mental Health
 Discussion
Overview
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3. Clients, families and funders want service providers across human services to
work as integrated service systems to better meet their needs with:
⁄ Coordinated access so that people know where to go
⁄ Consistent services regardless of where a client is served
⁄ Smooth hand-offs between services and providers
⁄ Best practices used wherever a client is served
Government has responded in several sectors by establishing:
⁄ Local Health Integration Networks in health care
⁄ Lead agencies in child and youth mental health
⁄ “Collaboratives” in adult mental health
⁄ Networks of Specialized Care in developmental services and mental health
⁄ Provincial agencies such as:
⁄ Ontario Centre of Excellence in Child and Youth Mental Health
⁄ Health Quality Ontario
From “Services” to “Service Systems”
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4. Diagram: John Kania & Mark Kramer,
Stanford Social Innovation Review 2011
Why Collaborative
Governance is Needed?
March 8, 2017 CMHO Collaborative Governance Webinar
⁄ All players have to change to
achieve the desired outcomes
⁄ Contractual relationships
require us to pursue integration
⁄ Board’s set direction and
measure performance against
objectives
⁄ Boards can’t do a good job of
strategic and generative
governance without engaging
in collaborative governance
⁄ It is in the best interests of
the people we serve
Collective Impact
4

5. Collaborative governance is and is not!
.
Is NOT… IS…
Board-level merger
or integration
Multiple Boards partnering
together to collectively achieve
results for shared stakeholders
A “Super Board”
Less about structure and more
about process, relationships and
communications
An additional
level of
governance
A response to the demand for
greater integration and
partnerships amongst providers.
Competition
among peers
Collaboration among stakeholders
to meet the needs of shared
populations
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6. Collaboration – 4 Ts
http://www.actforyouth.net/youth_development/communities/collaboration.cfm
It takes Time to build Trust through Transparency
to address Turf
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7. Examples of Collaborative
Governance in Ontario LHINs
• North Simcoe Muskoka LIHN
• Mississauga Halton LHIN

8. Care Connections Implementation Structure Current State
7.Communications
and Community
Engagement
8. Governance
9. Information
Communication
Technology/ eHealth
10. Integrated
Health Human
Resources
11. System
Navigation
12. Transportation
Complex Continuing
Care
Chronic Disease
Prevention and
Management
Behavioural Support
System
1. Complex &
Chronic Health
Needs
GBGH
Seniors’ Care
Strategy
Community
Capacity Task
Groups
High User Analysis;
LTC Capacity; and
Assisted
Living/Supportive
Housing
2. In Home &
Community
Capacity
CCAC/ILS
Developmental
Services
3. Maternal
Newborn Child &
Youth / COP
OSMH
Child & Adolescent
Mental Health &
Addictions
Acute Care Clinical
Services
Crisis Response
and Community
Resources
4. Mental Health
& Addictions
Waypoint
Critical Care System
Integrated Vascular
Care System
Emergency Care
System
5. Medicine
RVH
Musculoskeletal
Program
6. Surgery
CGMH
LHIN LHIN LHIN LHIN CCAC County of Simcoe
Inter-facility
Community
Standardization of
Process and Policy
Information &
Referral
Organizational
Development
Workforce Planning
and Education
Recruitment and
Retention
Transitions of Care
Maternal Child
Standards
Maternal Mental
Health
NSM LHIN Leadership Council &
Care Connections Steering Committee
Care Connections Operations Committee
Legend
Lead Organizations
Coordinating Councils
System Enablers
Project Steering
Committees
Regional Cancer
Includes 41 distinct
projects

9. Integrated Regional and Sub-LHIN Regional Model (Future State)
Sub-LHIN Integrated Delivery and
Coordination Management Team
Priority
Collaborating
Councils (for LHIN-
wide Integrated
Programs & Specialty
Services)
Enabling Councils
Provincial Programs
Leadership
Standards
Resource
Allocation
Oversight
Delivery
Primary
Health Care
Leadership Council
Patient
and
Family
Self-Care
Longer-
Term
Care
Post-
Acute
Care
Acute
Care
Commu-
nity
Services
LHIN Oversight
Future State
Service Delivery
Model
Core Collaborating
Councils (for LHIN-
wide Integrated
Programs & Specialty
Services)
Leadership
Standards
Resource
Allocation
Oversight
Delivery

10.  As in the MH LHIN, early work identified the need for governance training
 Provided Governance 101 and now 201 at a LHIN-wide level
 Using the sub-regions of the LHIN as the basis for the governance discussions
 System planning is at the sub-region level and each is taking a different path
Muskoka: MAHST Charting the course…Integrating Health Care
South Georgian Bay: Regional alignment of Quality Improvement Plans
North Simcoe Muskoka LHIN
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11. Mississauga Halton LHIN
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Community
Governance
Consultation
Group
G2G
Regional
Quality Table
LHIN-CCAC
Joint
Assessment
Reports to the
LHIN Governance
Committee
Provides input into
the agenda for
quarterly G2G
Provides advice on
LHIN priorities (i.e.
IHSP and
accreditation.
HSP Board and
CEOs with
LHIN Board and
Senior Team
Generative
discussions –
Educational
component with
guest speakers
Developing
integrated regional
quality plan
Building a culture of
quality care
Fostering innovation
Building capacity
Undertook joint
assessment of the
LHIN-CCAC
interactions
including budget
development,
multi year
planning, and
common projects

12. • Initiated Governance to Governance (G2G) very early on.
• A forum to foster interaction of health service providers with each other and
the LHIN and promote education and trust.
• Participants: HSP Board Members and Executive Directors/CEOs with
LHIN Board Members and Senior Team
• Started with an independent Facilitator but now use LHIN staff.
• Intermingled seating plan with a LHIN board and or staff member at each
table for more engaged and constructive conversations.
• Generative discussions – opportunity for open, interactive dialogue.
• Educational component with guest speakers followed by a staff facilitated
discussion at the individual group table level.
MH LHIN G2G
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13. Collaborative Governance in
Child and Youth Mental Health

14. Capitalize on Previous Collaborative Governance Assets
Coalition of Child Youth and Family Services (40 member agencies/services)
established in 1999, including previous Board to Board engagements.
Purpose of Current Moving on Mental Health (MOMH) Collaborative Governance
1. Catalyze collective board involvement and responsibility for System Change.
2. Embed MOMH ownership in community governance, not just Lead Agency.
3. Develop and “live” a common vision for child and youth mental health.
Collective Governance Process
First Session with Core Service Providers Board reps: Initial vision development for CYMH in
the service area, updates on the core services plan and potential priorities for the two plans.
• Wanted to make sure the boards received updates directly from the Lead Agency
• Discussion was wide-ranging, which was good
Second Session: shared and analyzed strategic plans from 5 core service providers, seeking
common visions and strategies, as well as strategic gaps.
• Established a portal for board members to access information
Planned Third Session: Open up the engagement process to other non-core service but
allied providers: Hospital Board, LHIN Board, School Board Trustees, etc
• Linkage of common visions, yielding a Simcoe County vision for child and youth mental
health
Simcoe County Lead
Agency Experience
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15. Just Do It! Board members are keen to meet colleagues from other agencies!
► Keep the sessions open to all board members rather than asking for a
designated representative; Senior Staff representation is welcome;
► Ensure the process is governance organized and sustained;
►Keep discussions at a high level as opposed to discussions of specific issues
in each agency; focus on the common vision and mission for CYMH;
►This will help when difficult decisions need to be made about services later;
►Value Added: Some agencies said that they have difficulty recruiting; so
they are considering sharing board members;
►Started with Saturday mornings to help with board member access;
►Important to have good independent facilitation so everyone participates;
►Anticipated outcomes are similar to Collective Impact but more of a
“developmental” approach.
Simcoe County Lessons
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16.  How does this information compare to what is developing in your region?
 How much time does your board spend on systems versus organizational
priorities?
 How much time should your board spend on systems versus organizational
priorities?
 What about your CEO? How much time and effort is reasonable for your CEO
to spend on system issues/priorities?
 What does this mean for your Board?
 Does your Board need to do anything different?
Discussion
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17. LOUGH BARNES CONSULTING GROUP
439 University Ave., Suite 1920
Toronto, ON M5G 1Y8
T/ 416.977.3811
www.loughbarnes.ca
We are creative and dedicated professionals with strong social
values and a commitment to our communities, especially to
those who are most vulnerable.
Our vision is to build stronger communities through positive
social change, a collaborative approach and our Social
Investment Fund.
Our mission is to contribute to improving human services
through high quality consulting and our Social Investment Fund.