Application for Membership to the Board of Directors

No individual shall be qualified for election or appointment as a Director if the individual:
i. is under 18 years old;
ii. has been found under the Substitute Decisions Act, 1992 or under the Mental Health Act to be incapable of managing property;
iii. has been found to be incapable by any court in Canada or elsewhere;
iv. has the status of a bankrupt;
v. is an “ineligible individual” as defined in the Income Tax Act (Canada) or any regulations made under it;
vi. is a current employee or Professional Staff member or lives in the same household as a current employee or Professional Staff; member; or
vii. is a former employee or Professional Staff member, or lives in the same household as a former employee or Professional Staff member, unless the Board otherwise determines.
The decision of the Board as to whether or not a candidate is qualified to stand for election shall be final.
In addition,
(a) A Director is expected to commit the substantial time required to perform board and committees duties.
(b)Directors must fulfill the requirements and responsibilities of their position – for example, preparing for and attending board and committee meetings, upholding their fiduciary obligations, thinking strategically and independently, and working cooperatively and respectfully with other Board members.
(c) Directors must comply with legislation governing the Corporation, the Corporation’s by- laws and policies, and all other applicable rules.
(d) Directors must sign a declaration confirming their agreement to adhere to their fiduciary duties, commitment to a regional approach to healthcare delivery, and Board and Corporate policies.
(e) Appointment of a Director is subject to background and reference checks, including a criminal reference check.

Please provide the name and contact information for three references related to your Board/governance experience below:

The Board seeks a complementary balance of knowledge, skills and experience. Please complete Schedule A of this form to indicate your level of knowledge, skills and experience.

Please indicate your level of knowledge and experience by checking off the relevant box for each category in the questions below (definitions and rating scale included on next page).
Note that it is not expected that Directors possess knowledge, skills and experience in all areas

Outstanding/Above Average: possesses ability / knowledge / demonstrates behaviour at an exceptional level, a role model.

Fully Satisfactory: possesses ability / knowledge / demonstrates behaviours at the level expected of a Director.

Adequate: possesses ability / knowledge / demonstrates behaviour, but may be inconsistent in demonstration, or minor weakness that could be improved.

Could Improve: would benefit by modifying this aspect of his/her skills to confirm to the expectations.

N/A: cannot access the individual on this question; lack of exposure to, or knowledge of, demonstrated behaviours or traits.

Strategic Thinking: Demonstrated ability to contribute to the vision of the organization, understanding the impact of socio/political/economic/technological/healthcare developments

Risk Management: Demonstrated ability to think critically about operational and governance issues to ensure effective management and proactive mitigation of potential risks and adverse effects

Systems Thinking: Demonstrated ability to identify patterns and trends, analyze root causes of issues, and approach challenges and opportunities by integrating multiple perspectives and viewpoints.

Building and Maintaining Stakeholder Relationships: Demonstrated ability to build strategic and leverageable relationships with key stakeholders such as government officials, community leaders.

Interpersonal Communication: Demonstrated ability to communicate effectively, and to persuade and influence; balance assertiveness and listening skills appropriately.

Results Orientation: Demonstrated ability to focus on measurable goals and results, understand and drive outcome-focused action plans.

Critical Thinking: Demonstrated ability to critically review proposals, provide independent opinions to improve plans and strategies.

Change Management: Demonstrated ability to support large scale change, through an understanding of change management strategies and tactics.

Ethics & Integrity: Strong moral compass, ability to act with, and role model integrity, alignment with the ethics and values of the Corporation.

Teamwork Orientation: An orientation to work collaboratively and respectfully with others.

Political Acumen: Possessing political savvy, ability to identify issues and related impacts and influencers.

Energy & Commitment: Time to devote to Corporation, a passion for the purpose, and a commitment to acting in the best interests of patients and community served.

Judgement to Recognize and Manage Conflicts of Interest: Demonstrated ability to recognize and manage specific conflicts of interests that arise from time to time.

Dealing with Ambiguity: Tolerates uncertainty well and comfortable in a dynamic environment by being open to new ideas, flexible and adaptable.

Constructive Conflict Management: Demonstrated ability to engage in respectful differences of opinions, and resolve effectively to enhance decision outcomes.

Academic/Education/ Research Orientation: An orientation towards or background in research, medical education, and/or university-affiliated activities.

Awareness and Commitment to Local Community: Knowledge of, and passion for local community needs and priorities; insightful about effective engagement strategies.

Diversity Orientation: Understanding, recognizing and supporting individual differences along the dimensions of race, ethnicity, gender, sexual orientation, socio-economic status, age, physical abilities, religious beliefs, political beliefs, or other ideologies.

General Business Management: Knowledge of activities and functions of running an organization, such as leading, directing and managing people and resources to achieve specific goals.

Governance and Fiduciary: Demonstrated experience or training in governance principles and practices such as through a chartered Directors or Institute of Corporate Directors programs, plus previous Board experience.

Financial Literacy: The ability to: Read and analyze, in a basic way, the financial statements of the Corporation and notes thereto; Understand the accounting policies of the Corporation, and assess the appropriateness of judgements and estimates when these are discussed by management and the external auditor; and Understand the Corporation’s business, including related risks, and any unique features related to it and its operations that may impact the accounting policies.

Healthcare and Community Health: Knowledge of Ontario’s Healthcare system.

Accounting and Finance: Accreditation as a financial professional (CPA).

Government Relations: Understanding and experience in the healthcare industry Healthcare Administration and Policy/Clinical. Exposure to health system policy, transformation and funding models, health system governance.

Quality, Patient Safety and Performance Management: Exposure to monitoring/evaluating healthcare quality and safety initiatives and overall performance metrics.

Construction and Project Management: Exposure to infrastructure and development matters, real estate, construction contracting and municipal requirements.

HR and Labour Management: Exposure to human resource strategies, executive compensation and union management relations.

IT and Cybersecurity: Exposure to the use of information and application of technology in organizations; understanding of benefits and risks of large scale implementations; understanding of current trends in big data and cyber that may impact Corporation.

Legal: Knowledge of legal concepts/issues of the Corporation and the legal framework in which the Corporation operates.

Patient and Healthcare Advocacy: Exposure to engaging and influencing multiple constituencies on health care positions.

Public Affairs and Communication: Exposure to public/community engagement strategies and impact on Corporation’s public reputation.

By submitting this application, I declare the following:
(a) I meet the eligibility criteria and accept the conditions of appointment set out above;
(b) I certify that the information in this application and in my resume is true.