Presentation to Shared Services in Healthcare Kelowna, BC Building a Leading Shared Services Provider

1. Presentation to Shared Services in HealthcareKelowna, BCBuilding a Leading Shared Services Provider June 23, 2009

2. Overview New Brunswick Health System Mandate from Government Strategic Goals Transition Principles & Plans Benefits to the system Organizational Governance Transition Governance Operating Governance Challenges Go Forward

3. New Brunswick Health Structure Speaking notes: As members of the Board, governance is always top-of-mind for you. As this slide illustrates, the RHAs and FacilicorpNB both have accountability to the Minister. We also both report to a Board of Directors. In previous conversations we�ve had, the issue of liability has come up. It�s important to note that since we�re members of the same family, all parties are protected from liability by HSLPP. Speaking notes: As members of the Board, governance is always top-of-mind for you. As this slide illustrates, the RHAs and FacilicorpNB both have accountability to the Minister. We also both report to a Board of Directors. In previous conversations we�ve had, the issue of liability has come up. It�s important to note that since we�re members of the same family, all parties are protected from liability by HSLPP.

4. Regional Health Authority A Population served (approx.): 1/3 Budget: 590 M $ Employees: 7,600 Doctors: 470 Volunteers: 1,200 Hospitals : 11 Foundations : 9 Community Health Centres : 6 Public Health/Mental Health Offices : 21 Extra Mural Program Offices : 10

5. Regional Health Authority B Population served (approx.): 2/3 Budget: 915 M $ Employees: 12,500 Doctors: 924 Volunteers : 3,500 Hospitals: 12 Foundations : 20 Community Health Clinics: 9 Public Health/Mental Health Offices : 30 Extra Mural Program Offices : 17

6. AmbulanceNB Managed by Medavie Blue Cross 133 standardized ambulances 106 000 calls answered in 2008 860 paramedical workers 1 medical director Air Ambulance (1 plane) About 40 dispatchers

7. New BrunswickHealth Council (mandate) The New Brunswick Health Council fosters transparency, engagement, and accountability by: � Engaging citizens in a meaningful dialogue. Measuring, monitoring, and evaluating population health and health service quality. Informing citizens on health system�s performance. Recommending improvements tohealth system partners.

9. Mandate from Government Create a new Part III company under the Business Corporations Act Consolidate responsibility for certain non clinical services on a phased basis over three years Eliminate duplication and competition Standardize processes and products Save $20 million annually by the end of year 5

10. Strategic Goals Consolidate responsibility for specific, non clinical services over the next three years Streamline process to ensure efficiencies Bring best practices province wide Increase capacity within the lines of business (IT and Materials Management) Save $20 million annually by the end of year 5 to reinvest in New Brunswick healthcare system

11. Transition Principles

12. Benefits to NB Healthcare System Lower costs Cost savings from group purchasing provincially Eliminate duplication of non-clinical services Reduce administrative overhead Standardize on best practices and processes Improve data and decision support tools Redirect savings to advancing health technology More strategic approach to the delivery of services More strategic approach to the delivery of services

13. Governance Organizational Transitional Operational

14. Organizational Governance Options Considered: Government Agency (Part III) Government Corporation (Part IV) Privatized Company Outsourced Services Suggested speaking notes: These are our guiding principles. We feel strongly they must be rooted in partnership and cooperation. Together, our teams have years of experience that will only improve our processes, our work and our facilities.Suggested speaking notes: These are our guiding principles. We feel strongly they must be rooted in partnership and cooperation. Together, our teams have years of experience that will only improve our processes, our work and our facilities.

15. Criteria for Assessing the Models Meet the service delivery needs of government and RHAs (Allow for protection of public interest) Increase the efficiency of service delivery (Best practice and ability generate savings) Responsible use of financial resources (Minimize costs of implementation and be self-financing) Minimize implications of implementation (Disruption of services)

16. Government Agency (Part III) Model similar to Regional Health Authorities (RHAs) Incorporate under Business Corporations Act Employees could be transitioned from RHAs under existing collective agreements Subject to essential services designation All savings and efficiencies accrue to government

17. Government Corporation (Part IV) Model similar to NB Liquor Corporation Establish through legislation or Business Corporations Act Future collective agreements responsibility of corporation Difficult to get essential services designation All savings and efficiencies accrue to government

18. Privatized Company Model similar to Nav Canada Established through Business Corporations Act Broad ownership with key stakeholders � government, RHAs, employees Employer � Corporation All savings and efficiencies accrue to government or the health system Not subject to essential services designation

19. Outsourced Services Private sector provider, similar to ambulance outsourcing in Nova Scotia Performance-based contract Employer � private sector RHAs must keep current employees Not subject to essential services legislation Savings and efficiencies shared between private sector and government

20. Option Selected Government Agency (Part III) Continuity of service delivery Least costly to implement Respects existing collective agreements Government owned (all revenues from government) Less time to implement Provided overall best opportunity for savings

21. New Agency Established March 2008 Named FacilicorpNB Head Office � Saint John, NB Distributed service delivery model Over 565 employees Another 400+ people to be transitioned

22. Transition Governance

23. Steering Committee Work stream Activities Define Scope of Service Develop base line data collection tools Collect and Analyze base line data Develop Service Level Agreements Develop Staff Transfer Plans Develop Operating proceduresWork stream Activities Define Scope of Service Develop base line data collection tools Collect and Analyze base line data Develop Service Level Agreements Develop Staff Transfer Plans Develop Operating procedures

24. Master Service Agreement Relationship Services to be provided Joint planning & priority setting Privacy & Confidentially Funding Principles Transparency Suggested speaking notes: This will be a real proof point for what we are discussing here today. Our SLAs will clearly translate our collaboration and planning into action. At the end of the day, this is all about accountability and results � which we take very seriously. Suggested speaking notes: This will be a real proof point for what we are discussing here today. Our SLAs will clearly translate our collaboration and planning into action. At the end of the day, this is all about accountability and results � which we take very seriously.

25. Service Level Agreements Relationship Management Services Base lining Roles & Responsibilities Change Requests Dispute resolution Decision making processes Service Level Measurements & reporting

26. April 1, 2009 Transition 550+ people - IT & Telecommunications and Materials Management Comprehensive Risk Management Plan Ongoing change management and communication planning Master Service Agreement and Service Level Agreements developed Established comprehensive Organizational Structure to deliver the scope of services Speaking notes: Absolutely terrific work has been done by the transition team. This is where all the planning we�ve done is going to pay off. Without the expertise of the RHA folks who live and breathe this world everyday, this could not have been done. We are all extremely fortunate to have had their knowledge and experience throughout this process. This will prove to be just as crucial as we move beyond April 1. Speaking notes: Absolutely terrific work has been done by the transition team. This is where all the planning we�ve done is going to pay off. Without the expertise of the RHA folks who live and breathe this world everyday, this could not have been done. We are all extremely fortunate to have had their knowledge and experience throughout this process. This will prove to be just as crucial as we move beyond April 1.

27. Operational Governance

28. Operational Governance (IT) RHA wide e-health committees Establish vision and strategic direction for e-Health within the RHA Oversee the prioritization, evaluation, planning and implementation of e-Health initiatives within the RHA Joint Leadership & Planning Committees established with the RHAs, Ambulance NB & Department of Health Joint Planning and Priorities Setting The Parties will consult in a meaningful manner with each other and will work collaboratively to participate in the planning and the establishment of each Party�s priorities, it always being understood that the business plans of a Party are the ultimate decision of the Party and its board of directors. IES /FacilicorpNB Joint Leadership Committee and IT Joint Planning Committee Planning committee will allow all parties to work to achieve a common agendaJoint Planning and Priorities Setting The Parties will consult in a meaningful manner with each other and will work collaboratively to participate in the planning and the establishment of each Party�s priorities, it always being understood that the business plans of a Party are the ultimate decision of the Party and its board of directors. IES /FacilicorpNB Joint Leadership Committee and IT Joint Planning Committee Planning committee will allow all parties to work to achieve a common agenda

29. Interim Accountability until Service transfer

30. Challenges

31. Going Forward Continued collaboration Even more planning and communication Accountability to RHAs, the province, staff and patients Speaking notes: We know our work doesn�t stop April 1st. The guiding principles we shared with you earlier will continue to be with us throughout this process. We believe strongly in accountability and have many groups that are looking to us for this. Change is never easy but it is necessary. We believe these changes will help in ensuring the sustainability and long-term health of our system. Speaking notes: We know our work doesn�t stop April 1st. The guiding principles we shared with you earlier will continue to be with us throughout this process. We believe strongly in accountability and have many groups that are looking to us for this. Change is never easy but it is necessary. We believe these changes will help in ensuring the sustainability and long-term health of our system.

32. Thank You