Ontario Health Team Self- Assessment Form Part I: General Information and Commitments Who are the members of your team? Health and service providers across the entire geography of the Niagara Region (population: 447,888) have committed to collaborate on one joint Ontario Health Team (OHT) Self ‘Assessment submission. These organizations have established several formal and informal partnerships that support successful delivery of integrated and coordinated patienticlient care services across the lifespan and continuum of care and have a successful track record of working together to improve population health outcomes for the residents of Niagara ‘AS a team, we are committed to ongoing collaboration in recognition of the collective benefits of a continued partnership to form one Niagara Ontario Health Team (Niagara-OHT). And more importantly, we acknowledge that this is the beginning of a journey, that there are knowns and unknowns and we will continue to evolve our discussions through more comprehensive planning to deliver on the vision of a full continuum of care that is integrated, innovative, and improves health outcomes, the patienticlientiprovider experience and ensures value for our broader Niagara community. ‘We are committed to adopting guiding principles and values to ensure a strong foundation of mutual respect, accountability and inclusivity to guide the vision and partnership work ahead. Niagara-OHT will proceed with its committed partners through the Full Application process (if accepted) and have agreed to maintain an ‘open-door' for new, existing and associated partners. Associated Partners include those where specific engagement (identified in the submission), additional time, Board engagement/decision, information and/or clarity is required regarding the Niagara-OHT submission, but have expressed interest to continue to work with Niagara-OHT through this process (see below) A glossary of terms and acronyms are appended for reference The list of committed and ‘associated’ partners are as follows: Committed Partners Associated Partners + Alzheimer Society of Niagara Region | Associated Partners include any organization ARID Recovery Homes that has agreed to be listed on the Benevolent Society “Heidehof for the | Submission without a formal commitment (at Care of the Aged this time), with many contnbuting to the Self «© Bridges Community Health Centre | A8sessment Form. Associated Members have expressed interest to continue to work * Brock University ~ Faculty of Health with the Niagara-OHT through the Full Sciences + Canadian Mental Health Association, | Application process and implementation Niagara and/or continued service partnerships, ‘community support and/or advocacy. Niagara-OHT has agreed to maintain an ‘open-door’ for new, existing and associated ‘+ Community Addiction Services of Niagara (CASON) + Community Support Services of Niagara partners. + ConcumeriSunvor inate of Niegors ; ‘ + Entité? de planification des services + Soniact Negara for Chisrens and aa santéenfangas” reves ele Language Health Planning Entity + Foyer RichelieuOntario Health Team Self- Assessment Form Gateway Residential and Community Support Services of Niagara Inc. Hospice Niagara Hotel Dieu Shaver Health and. Rehabilitation Centre (HDS) McMaster University - Niagara Regional Campus - Michael G. DeGraote School of Medicine Niagara College — Faculty of Community & Health Studies Niagara Falls Community Health Centre Niagara Health (Douglas Memorial site, Greater Niagara General site Port Colbome site, St. Catharines site, Welland site) and its partner St. Joseph's Health System Niagara Ina Grafton Gage Village Niagara Region Public Health & Emergency Services Emergency Medical Services Public Health Mental Health Services Community Services Seniors Services (Long-Term Care and Community Programs) Oak Centre Pathstone Mental Health Positive Living Niagara ‘Quest Community Health Centre Radiant Care ~ Pleasant Manor/Tabor Manor United Mennonite Home Home and Community Care — as part of Hamilton Niagara Haldimand Brant Local Health Integration Network (HINHB LHIN) March of Dimes Canada Niagara Medical Group Family Health Team Niagara North Family Health Team Portage Medical Family Health Team Registered Nurses’ Association of Ontario Wayside Niagara Welland MeMaster Family Health Team Commitment to collaborate with others @ Please confirm that you are willing to work and engage with other interested groups in your geographic area to collaborate towards becoming an Ontario Health Team, if recommended by the Ministry. Commitment to the Ontario Health Team vision {@ Please confirm that all proposed partners have read the Ontario Health Teams: Guidance for Health Care Providers and Organizations in full and are committed to working towards implementation of the Ontario Health Team Model.