NSM LHIN Action Plan:  Year 5 (2012-13) Pay-For-Results (P4R)
Request for Action Plan Submissions
Emergency Department (ED) Services

The NSM LHIN is issuing the attached DRAFT Action Plan Guidance & Template for the 2012/13 funding cycle to solicit the submission of Hospital-based P4R fixed-funding initiatives, designed to improve ED performance by addressing one or more of the following focus areas:  increasing ED capacity, reducing ED LOS or reducing ALC bed days (improving bed utilization).

An environmental scan of ED Performance Leads across the province in February and March, revealed that several LHINs had historically used available funds to fund initiatives to non-Hospital based HSPs (including the CCAC and CSS agencies).  Consequently, given this approach and the expected change to the Program to discontinue the recovery of funds due to unrealized performance, the NSM LHIN has structured its P4R Program in Year 5 with the following features:

  • Minimum of 80% of Total LHIN P4R Funds to be awarded for “hospital-specific” initiatives provided by public NSM LHIN Hospitals with active Emergency Departments (Note:  In Year 5, all public NSM LHIN Hospitals with active emergency departments are deemed eligible);
  • Up to 20% of Total LHIN P4R Funds to be awarded for “system-specific” initiatives available to all currently funded NSM LHIN HSPs (including NSM CCAC, CSS Agencies, CHC Agencies, MHA Agencies, etc.)  (Note:  A separate Expression of Interest (EOI) process will be used to identify, track and evaluate system-specific initiatives identified by all LHIN-funded health service providers, and has also been released today).

Please note that the formal announcement of the Year 5 ED Pay-for-Results Program by the Ministry of Health is anticipated shortly.  As such, all confirmed details related to performance measures, targets, funding allocations and timelines are not available at this time.  However, based on discussions held with the Ministry several months ago, it would appear that the total NSM LHIN funding allocation for hospital-specific initiatives in Year 5 will be similar to that received in Year 4. 

Upon notification of final Year 5 P4R Program and funding details, the NSM LHIN will communicate this Supplemental information to all Hospitals.  It is recognized that completed Action Plans submitted to NSM LHIN for review will be considered to be in DRAFT form, and will be subject to possible revision by the proponent upon receipt of confirmed Year 5 ED P4R Program information.

The release of the Action Plan Guidance & Template document (in Word 2003 Format) is intended to provide NSM LHIN Hospitals with an opportunity to begin the process of proposal development at this time.  Section A of the document provides an overview of P4R Initiatives funded in Year 4 and is provided to proponents to assist in developing Year 5 Action Plans.  Please review this section for accuracy and completion, and make corrections and/or additions as appropriate.  Complete Section B with proposed initiative(s)/ED improvements that your Hospital wishes to submit for consideration.  Please include all funding, human resource and costing details along with your submission in Excel format. 

The determination of successful Year 5 ED P4R Initiatives will not be made by NSM LHIN until it has received the formal communication of the Program (along with LHIN funding allocations) from the Ministry of Health and Long-Term Care.

The NSM LHIN is interested in receiving completed DRAFT Action Plans from public Hospitals with active Emergency Departments currently funded by the NSM LHIN. 

For the Word version of the Draft Action Plan, please click here.

The deadline for submission of proposals is 12:00 noon, Thursday July 19th, 2012.  Please submit the completed Draft Action Plan and supporting documentation via email to:  Brian.Putman@lhins.on.ca.

Questions - Answers

Q1. Are the funds for the P4R Expression of Interest for system-specific Initiatives annualized or one-time funds? 

A1.  The funds are one-time.


Q2. The EOI is One-time although the EOI states: “Expression of Interest (EOI) for System-Specific Initiatives The NSM LHIN is issuing an EOI for the 2012/13 funding cycle to support direct system-specific solutions that will address Emergency Department performance improvement. This EOI assumes funding on an annual basis.”

A2.  The P4R funding is one time funding awarded on an annual basis and is based on performance. Therefore, if the project performs and meets the expected outcomes it will be awarded funding for the following year. If it does not performance, funding will be clawed back. The guidelines for performance are issued every year and Year 5 P4R guidelines have not been issued. In summary, P4R is recurring one-time based on performance.


Q3. Is the funding for 12 months from October or do we have to have the initiative completed by the end of the fiscal - by March 31, 2013?

A3. The initiative is to be completed by the end of the fiscal - by March 31, 2013 


Q4. Is the EOI of $800K for the entire LHIN and that each application cannot exceed $800? 

A4. Yes The P4R EOI is for $800,000 for the entire LHIN. Therefore, any one proposal cannot exceed this amount.


Q5.  How do I provide a) Service Code Description b) Annualized Units of Service if this section does not apply?

A5.  In this section we would like you to provide the service details you would provide in your WERS reporting. In the same way as you would capture the service description and the delivery of the service for existing service reporting to the LHIN.