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Durham OHT EOI – Budget & Operational Framework

Welcome, colleagues —

This page contains a working draft of the Durham OHT Expression of Interest proposal, including operational and budget considerations developed for the L1T postal code initiative. This page is shared securely with the planning team for review and feedback.

Please enter the password provided to access the full content. For questions or collaboration, feel free to contact Dr. Carlos Yu directly.


EOI – Operational and Budget Considerations

Ajax Harwood Clinic & Regional Physician Wellness Supports
Submitted by Dr. Carlos Yu – April 2025

Section A: Clinic Onboarding Support – Ajax Harwood Clinic

Goal: Roster 400–600 new patients in the L1T area within 12 months.

Rationale: Based on Ontario’s recent investment of $110 million to support primary care access for 328,000 individuals (approx. $335 per patient), this proposal aligns with expected funding envelopes. For 6,000 patients, this equates to a feasible budget target of ~$2 million.

This model prioritizes patients with the highest need — including those with mental health conditions, complex chronic disease, and high system utilization. These patients drive disproportionate costs in emergency, specialty, and inpatient care. By supporting them effectively at the primary care level:

  • We reduce downstream system burden, including ER visits and hospital admissions.
  • We address mental health-related productivity losses and inefficiencies through group care and structured support.
  • We reduce physician burnout through structured onboarding and team-based support.
  • We intervene early in metabolic syndrome trajectories to prevent escalation.

Even if not all 6,000 patients can be attached immediately, this investment creates the infrastructure to welcome them when they are ready—and delivers measurable return to the system for those who do engage.

Budget Breakdown:

CategoryDescriptionEstimated Annual Cost
RN Care Navigator (0.6 FTE)Intake triage, orientation, EMR setup, health needs screening$65,000
MOA/Admin Support (0.5 FTE)Scheduling, follow-ups, referral support$35,000
Empowered Care Platform Dev & ExpansionDIPA compliance, secure hosting, multi-clinic onboarding, training & toolkits$75,000
Infrastructure ExpansionClinic readiness for additional physician(s)$10,000
Subtotal – Clinic Support$185,000/year

Note: Empowered Care is designed as a scalable asset across L1T clinics. It supports digital onboarding, documentation, patient self-orientation, and group medical visit facilitation. It will require ongoing platform support and tech refinement throughout the year to scale effectively.

Section B: Mental Health & Chronic Disease Pathways

CategoryDescriptionEstimated Annual Cost
Diabetes Educator (1.0 FTE, shared)Shared across clinics; insulin starts, group education$90,000
Group Mental Health Facilitator (0.5 FTE)Supports onboarding of patients with trauma/anxiety$45,000
Contingency – NP/RNOverflow or high-complexity support$60,000
Subtotal – Clinical Pathway Support$195,000/year

Section C: Physician Wellness Model – Co-Facilitated, Peer-Based

CategoryDescriptionEstimated Annual Cost
Physician Participation Stipend12 monthly circles × 20 physicians × $250$60,000
Presence Therapy CMEAccredited program – 2 cohorts/year$20,000
Admin SupportScheduling, outreach, logistics$18,000
Subtotal – Wellness Supports$98,000/year

This model supports physician resilience and reduces burnout. Each participant is equally compensated, and sessions focus on presence, connection, and shared system improvement.

Section D: Rollout Timeline & Budget Overview

PhaseDescriptionBudget
Start-up (Months 1–3)Team onboarding, Empowered Care setup, clinic prep$125,000
Operational (Year 1)Full rollout of patient attachment & care models$400,000–450,000
Post-Year 1Continued support for pathways and wellness programming~$175,000/year

Optional Expansion: L1T Community Site

  • A pharmacy site on Williamson Rd may serve as a satellite intake/group care location
  • Currently underutilized and centrally located within L1T
  • May operate as an extension of Ajax Harwood or as a standalone health node
  • Open to exploration if aligned with team goals