Frequently Asked Questions

 
About Ontario Health Teams
What are Ontario Health Teams?

Ontario Health Teams are groups of health and community care providers and organizations that, at maturity, will be clinically and fiscally accountable for delivering a full and coordinated continuum of care to a defined population.

At maturity, every Ontarian will have the opportunity to access care from an OHT.

What is expected of an OHT?
  • Patients receive their care from one integrated system in a region
  • 24/7 patient navigation support
  • High use of digital tools for population health
  • Governance is self-determined and will evolve
How do the providers relate and work together in OHTs?
The Ontario Government has tasked physicians (primary care and specialists) and other providers (hospitals, home care, mental health etc.) to voluntarily come together and self-organize to design and deliver a coordinated continuum of care to a defined population or group. OHTs are changing how healthcare is delivered in the province so that patients receive better integrated care in their community.
What are the potential risks and benefits for family physicians to join OHTs?

Potential Benefits:
If OHTs operate as intended –at maturity–you should see:

  • Supports for you and your patients;
  • Local solutions for health system navigation;
  • More timely access to specialists and community resources;
  • Decreased administrative burden and paperwork, freeing up your time;
  • Improved used of technology (i.e., virtual care, EMR integration).

Potential Risks:

  • How gain and risk sharing will be applied across organizations remains unclear;
  • Expectations of FPs as OHTs roll out are unclear at this time,
  • Levels of interest and readiness to participate in OHTs vary among FPs;
  • FPs will be asked to give more of their time, increasing risk of burnout;
  • With varying levels of FP involvement, some communities will be farther ahead than others;
  • Without FP voices at the table, system changes will proceed without FP perspective and expertise.
Why is it so important for family physicians to be involved from the beginning?

Family physicians (FPs) see more patients than any other part of the healthcare system and know first-hand where the system has fallen short and where more help is needed. The evidence is clear: organizations that effectively engage physicians in health system design, change processes, and leadership development opportunities are more likely to experience improved outcomes.

Why do OHTs need the involvement of family physicians?
Physician leadership is key to the success of integrated systems like OHTs. Evidence shows that physician leadership, voluntary participation, and a primary care-based approach are essential to the success of integrated healthcare delivery systems like OHTs. The OMA strongly encourages all physicians (including both primary care physicians and specialists) to get involved in OHT governance to ensure the collective physician voice is heard.
Can I choose which OHT to join?
Physicians can choose which OHT to join. As groups continue to assemble and work towards becoming OHTs, the Ministry of Health will identify one that might be appropriate for you to join. It will include the acute care hospital where most of your patients receive in-patient care. This is a suggestion only. You should join the OHT that you feel is the best fi t for your practice. It should include organizations where most of your patients access care. And if you do choose to participate in an OHT, you can join either as an individual or as part of an organization (like a FHO or long-term care home).
Can I join more than 1 OHT?

Yes, you can join more than 1 OHT.

We know family physicians generally have may patients residing in different OHTs.

Family physicians would like to help their patients to receive their care from one integrated system within an OHT. Therefore it is important that each family physician is free to join many OHTs so that they can navigate their patients to appropriate and integrated care near where they live. Family physicians also need to consider a minimal threshold of patients they have residing in an OHT before joining a particular OHT.

Is physician participation voluntary?
Physician participation in OHTs is voluntary. You can choose whether or not to join an OHT. Your participation is voluntary regardless of whether you work in a hospital, an independent practice, or a group practice. The OMA does not anticipate any negative impact to your practice if you decide not to participate in an OHT. Rather, participating in the early stages of development will give you an opportunity to help shape your OHT.
Would joining or not joining OHT affect how I am renumerated?

OHTs will not affect how you are paid at this time. The OMA does not anticipate any changes to existing physician compensation models at this time. This is true regardless of your specialty and practice type, or whether you decide to participate in an OHT. Once OHTs are fully developed, the government intends to prospectively fund them with a single integrated funding envelope. The funding envelope for each OHT will vary depending on the needs of its patient population (similar to how hospitals are funded today).

Any changes to physician compensation would have to be negotiated with the OMA.

Who can I contact if I have questions?

If you have questions about Ontario Health Teams, please email ontariohealthteams@ontario.ca or visit OMA and Ontario College of Family Physicians web sites.

When are Ontario Health Teams being announced?
OHTs have been announced in waves since fall of 2019. The total number of OHTs in Ontario is now 42, including Scarborough OHT which was approved in October 2020.
Who can become a member of an Ontario Health Team?
All healthcare providers and patient representatives are potential members of OHTs.
How does a patient become connected with an Ontario Health Team?
Any patient can access OHT services through any organization or physician affiliated with the OHT.

Further information can be found on the Ontario Ministry of Health website at:

http://health.gov.on.ca/en/pro/programs/connectedcare/oht/default.aspx#FAQ
About Scarborough Ontario Health Team (S-OHT)
Is Scarborough Family Physicians Network (Scarborough FPN) part of the S-OHT?

The Scarborough FPN officially joined the S-OHT on December 7, 2020.

The S-OHT is composed of six Sectors and two Special Groups:

Sectors:

  • Community Support Services
  • Home Care
  • Hospital • Long-Term Care/Retirement Home
  • Mental Health & Addictions
  • Primary Care (non-physician)

Groups:

  • Client Family Advisory Committee
  • Scarborough Family Physicians Network
What is the governance structure and the representation of family physicians in the S-OHT?

The collaborative decision-making body of S-OHT, called the Collaboration Council (CC), will be comprised of representatives of each of the above-listed Sectors and Groups. The total number of representatives on the Collaboration Council will not exceed twenty-four (24) (and ideally will be reduced as the model is refined to align to evolving OHT functions and trust among the partners continues to grow) but the numbers of representatives for particular Sectors/Groups may change over time by decision of the Collaboration Council depending on relevant factors as determined by the Council.

Currently Scarborough-FPN has 8 out of 24 representatives on this Collaboration Council. It is expected that collaborative decision-making arrangements will evolve as OHTs develop, expand, and mature. We will endeavour to maintain 1/3 representation on this Collaboration Council when the size is gradually reduced in the future.

The S-OHT has adopted the Collaborative Decision Making approach recommended by the Ministry. This approach means that every effort will be made to reach decisions by consensus and voting will be a rare occurrence.

The Ministry now uses the term “collaborative decision-making arrangements” rather than the term “governance” to reflect that OHTs are still in early stages of implementation, including that: at this time, patient services continue to be funded and governed by agreements between the funder and each member within an OHT, and not (yet) through an integrated agreement between the funder and the OHT as a whole; and OHT members need time to work out the scope of decision-making they assign to the OHT (vs. the scope of decision-making authority retained by individual members).

The use of this term also recognizes that community context differs from region to region, including that providers (including provider organizations and solo practitioners) in different OHTs will take different (and evolving) approaches to defining their roles, responsibilities, and relationships within their OHT. The intention in using this terminology is to focus on defining the mechanisms through which a foundation for collaborative decision-making can be built to support and enable progress towards a more mature state, including the delivery of integrated patient care services across the OHT.

How many partners have joined the S-OHT?

All current partners will be grouped voluntarily into one of six sectors. The current partners in S-OHT are:

Scarborough Family Physicians Network (S-FPN, http://scarboroughfpn.org)

Scarborough Health Network (‘SHN’)

Carefirst Family Health Team (‘Carefirst FHT’)

Carefirst Seniors and Community Services Association (‘Carefirst’)

Canadian Mental Health Association Toronto (‘CMHA’)

Community Family Services Organization (CFSO)

COTA Health

East GTA Family Health Team (‘East GTA FHT’)

HF Connecting Health Nurse Practitioner-Led Clinic (‘HFCHNPLC’)

Hong Fook Mental Health Association

Inner City Family Health Team (‘Inner City FHT’)

Integrated Rehab Professionals (‘IRP’)/Pickering Sports Medicine & Wellness Centre

Kinatex Sports Physio (Markham)

Mon Sheong Foundation

Providence Healthcare/Unity Health

Saint Elizabeth Health Care (‘SE Health’)

Scarborough Academic FHT (‘Scarborough Academic FHT’)

Scarborough Centre for Healthy Communities (‘SCHC’)

Scarborough Retirement Residence

Senior Persons Living Connected (‘SPLC’)

Shepherd Lodge the Long-Term Care Home of Shepherd Village Inc.

Sienna Senior Living

Spectrum Health Care

S.R.T. MedStaff

Strides Toronto

TAIBU Community Health Centre

Tendercare Living Centre

The Care Company

The Housing HELP Centre (‘THHC’)

The Wexford Residence

Transcare Community Support Services

VHA Home HealthCare (‘VHA’)

Yee Hong Centre for Geriatric Care

When was the S-OHT established?
The S-OHT was approved by the Ministry of Health on October 23, 2020. However, the S-OHT partners have been working together to develop the OHT since May 2019.
What are the current vision and values of S-OHT?

The vision is: “People will have optimal health and positive experiences through an accessible, equitable and integrated system of care, services and supports.”

The values are Accountability, Respect, Equity, Collaboration, Compassion, Innovation, Person-centred, and Excellence.

How many people will the S-OHT serve?
It is estimated that the S-OHT will eventually serve approximately 898,831 people. This is the largest population assigned to an OHT in the province. Scarborough has 632,095 residents (Census 2016) but Ontario residents are attributed to an OHT based on where they access care, not where they live. Sixty-one percent of S-OHT’s attributed population lives in Toronto including Scarborough, 13% live in Markham, 5% in Ajax and 5% in Pickering
How will S-OHT ensure care is equitable across Scarborough’s diverse population?
Scarborough is one of the most diverse and multicultural communities in Canada with approximately 73% of residents identifying as visible minorities. These groups experience many barriers to accessing health care programs and services. In addition, the higher levels of poverty residents of Scarborough experience, compared to Ontario, contributes to poorer health outcomes. As a result, S-OHT has identified ‘reducing health and social inequity to achieve population health’ as a key priority for delivery of culturally appropriate, safe and equitable care for vulnerable populations.
What is the Year 1 Focus for S-OHT?
Our Year 1 focus is to improve and coordinate services for frail seniors living with mental health and/or addictions issues and multiple chronic conditions
What is S-OHT’s response to the COVID-19 pandemic?

Some of the initiatives S-OHT partners have put in place include:

  • Assessment Centres for COVID-19 Testing
    • Scarborough Health Network COVID-19 assessment centres.
    • COVID-19 mobile testing and pop-up assessment centres
    • Nurse Practitioner-led mobile testing team for Mental Health clients.
  • Community initiatives
    • Community education and health promotion, including safe isolation in various living arrangements, to educate racialized and marginalized communities about testing, preventing the spread and to dispel myths about the virus.
    • COVID-19 Response Collaboration – Central Line for CSS, one phone number to connect vulnerable individuals to wrap around programs and services.
    • Telehomecare COVID-19 remote monitoring program and testing support
    • TAIBU Together COVID-19 helpline and email.
    • PROTECH (Pandemic Rapid-response Optimization to Enhance Community-Resilience and Health).
    • Measures to support community education and engagement.
    • TAIBU and SCHC rolling out community education and health promotion initiatives under Toronto’s new COVID-19 Equity Action Plan
  • Long-term care facilities, retirement homes, nursing homes, etc.
    • SHN is helping to manage COVID outbreaks in several Long-Term Care (LTC) Homes
    • The LTC Incident Management System for COVID-19 brings together all LTC Homes in Scarborough along with SHN, Public Health and Ontario Health
How is S-OHT providing culturally appropriate services?

S-OHT partners include many organizations that have specialized expertise and a long history of meeting the needs of culturally diverse communities and newcomers.

Examples include:

  • Carefirst FHT and Carefirst Seniors Association (Chinese and Asian seniors)
  • Community Family Services Ontario (Chinese and other newcomer groups)
  • HFMHA – Asian communities (Cambodian, Chinese (Cantonese and Mandarin), Korean, and Vietnamese)
  • HF Connecting Health Nurse Practitioner Led Clinic (Asian communities)
  • Mon Sheong LTC Home (Chinese seniors)
  • TAIBU CHC (Black, Francophone and Indigenous communities)
  • Yee Hong Centre for Geriatric Care (Chinese and other ethnic seniors)
  • CMHA case management program (Afghani, Syrian/Arabic-speaking communities)
  • Canadian Centre for Immigrant and Refugee Healthcare
  • SHN (Interpretation services in dozens of languages; multi-faith Spiritual care)
How is S-OHT engaging clients and families?
A Client Family Advisory Committee (CFAC) has been established for S-OHT, which continues to grow. Representatives of the CFAC participate in the S-OHT Collaboration Council, as well as co-lead or participate in many of our working groups.