INFORMATION TECHNOLOGY SUB-COMMITTEEAGENDA 821 JUNE 2010 SOUS-COMITÉ DE LA TECHNOLOGIE DE L’INFORMATIONORDRE DU JOUR 8LE 21 JUIN 2010



Board of Health Corporate Seal

Ottawa Board of Health
MINUTES 4
Monday, April 15, 2019, 5:00 PM
Champlain Room, 110 Laurier Avenue W.
Contact for the Ottawa Board of Health:
Diane Blais, Board of Health Secretary
613-580-2424, ext. 21544
[email protected]

Board Members:
Chair: K. Egli
Vice-Chair: T. DeGiovanni
Members: E. Banham, J. Cloutier, E. El-Chantiry, G. Gower, T. Kavanagh, L. Leikin, S. Menard, S. Pinel, P. Tilley

The Ottawa Board of Health met in the Champlain Room, 110 Laurier Avenue West, Ottawa, on Monday, April 15, 2019 beginning at 5:00 PM.

The Chair, Keith Egli, presided over the meeting.


 

 

ANNOUNCEMENTS/CEREMONIAL ACTIVITIES

Chair Egli remembered Métis Elder Jo MacQuarrie who passed away on March 13, 2019 and invited everyone to stand for a moment of silence in her honour.

 

ROLL CALL

Member Leikin was absent.

 

REGRETS

Member Leikin sent regrets.

 

DECLARATIONS OF PECUNIARY INTEREST (INCLUDING THOSE ORIGINALLY ARISING FROM PRIOR MEETINGS)

No declarations of pecuniary interest were filed.

 

CONFIRMATION OF MINUTES

Confirmation of minutes of the meeting of March 4, 2019.

CONFIRMED

 

 

COMMUNICATIONS

Twenty-two communication items have been received (held on file with the Board of Health Secretary).

 

MOTION TO INTRODUCE REPORTS

Motion 4/1

Moved by Member El-Chantiry

BE IT RESOLVED THAT the Chair of the Board of Health Verbal Report, the Medical Officer of Health Verbal Report, and the reports titled Ottawa Public Health 2018 Annual Report, Dental Health Services for Low-Income Seniors, Ontario Public Health Standards – Accountability and Reporting Requirements, Ottawa Public Health Emergency Preparedness and Response, 2018 Operating and Capital Budget Year-End Results – Board of Health for the City of Ottawa Health Unit Status Report, Delegation of Authority – Contracts Awarded for the Period of July 1 to December 31, 2018, and Attendance at the Association of Local Public Health Agencies’ (alPHa) 2019 Annual General Meeting and Conference, be received and considered.

CARRIED

 

Following a ‘Consent Agenda’ process, the Board considered the held Items in the following order: Items 2, 1, and 4.

 

1.

CHAIR OF THE BOARD OF HEALTH VERBAL REPORT

 

ACS2019-OPH-BOH-0004

 

That the Board of Health for the City of Ottawa Health Unit receive this report for information.

 

RECEIVED, as amended by Motion 4/6

 

Chair Egli provided the Board with an update on recent events. The Chair’s verbal report took approximately 10 minutes. The Board then voted to approve Motion 4/6 and to receive the Chair’s verbal report.

The attached memo includes the Chair of the Board of Health Verbal Update.

 

Motion 4/6

Moved by Vice-Chair DeGiovanni

WHEREAS on March 29, 2019, the Ministry of Health and Long-Term Care informed Ottawa Public Health (OPH) that they would not be providing ongoing operating funds for OPH’s Consumption and Treatment Services, currently located at 179 Clarence Street;

AND WHEREAS Members of the Board of Health are unanimous in their disappointment with this decision and their belief that the services provided by OPH through its Consumption and Treatment Services are crucial to the more than 500 clients who have used these services since the site began operating on September 26, 2017;

AND WHEREAS the Chair of the Board of Health and the Mayor of Ottawa have written a joint letter to the Ontario Minister of Health asking her to review and reconsider this funding decision;

AND WHEREAS OPH is exploring all available options for ensuring these life-saving services can continue;

THEREFORE BE IT RESOLVED that the Board of Health for the City of Ottawa Health Unit authorize its Chair, Councillor Keith Egli, in collaboration with the Medical Officer of Health and/or other partners and stakeholders, as appropriate, to take any further actions that may be necessary and appropriate to secure ongoing funding for Ottawa Public Health’s Consumption and Treatment Services and to report back to the Board of Health as appropriate.

 

CARRIED

 

2.

MEDICAL OFFICER OF HEALTH VERBAL REPORT

 

ACS2019-OPH-MOH-0004

 

That the Board of Health for the City of Ottawa Health Unit receive this report for information.

 

RECEIVED, as amended by Motions 4/3 and 4/4

 

In the context of her Verbal Update to the Board of Health, Dr. Etches spoke to a PowerPoint presentation in which she described the work of local public health units and of Ottawa Public Health in particular, she referenced the importance of local partnerships in promoting and advancing public health policies and initiatives and she highlighted the value of public health in terms of improved quality of life and savings to the health care system in general. She also provided an overview of recent Provincial proposals for restructuring Ontario’s health system. In particular, she talked about:

·         The creation of Ontario Health Teams, the processes related to that and some of the preliminary discussions held to date with partners and colleagues; and

·         Announcements in the 2019 Provincial Budget, released on April 11, 2019, with respect to changes to the number of public health units in Ontario, their governance model and funding formula.

Following Dr. Etches’ presentation, and before hearing from public delegations, Chair Egli read two motions into the record:

Motion 4/3

WHEREAS the Provincial government’s 2019 Budget, released on April 11, 2019 announced some significant changes to how public health services in Ontario are structured, governed and funded;

AND WHEREAS there are many unknowns about how and when the Province proposes to implement these changes;

AND WHEREAS the Province is proposing to reduce the number of health units in Ontario from 35 locally-based health units to 10 regionally based health units;

AND WHEREAS local public health is known for its responsiveness to local needs, basing many of its programs and services on local evidence, data, and priorities;

AND WHEREAS the proposed restructuring is likely to result in a loss of local control and local responsiveness of public health programs and services;

THEREFORE BE IT RESOLVED that the Board of Health for the City of Ottawa Health Unit request that Ottawa City Council:

·         Request that the Mayor of Ottawa write to the Province of Ontario to communicate Council’s unequivocal support for the work of Ottawa Public Health;

·         Request the Province maintain the health protection, health promotion, and prevention mandate of Ottawa Public Health;

·         Request the Province maintain the current 75 percent provincial, 25 percent municipal funding formula for Ottawa Public Health and public health programs in Ontario; and

·         Request the Province initiate consultations with municipalities and public health agencies on the public health system in Ontario.

Motion 4/4

WHEREAS on February 26, 2019, the Ministry of Health and Long-Term Care announced Ontario Health Teams as a new way of organizing and delivering services to patients;

AND WHEREAS on April 3, 2019, information was released with respect to the guidelines and process for applications for Ontario Health Teams;

AND WHEREAS Ottawa’s Medical Officer of Health has engaged in preliminary discussions with local partners to explore the possibility of Ottawa Public Health (OPH) becoming a partner in Ottawa area-based Ontario Health Teams;

AND WHEREAS the first step in this process is the submission of self-assessments, due to the Ministry by May 15, 2019, and the subsequent step will be for selected groups to be invited to submit their full applications by July 12, 2019, with Ontario Health Teams being announced beginning in the fall of 2019;

AND WHEREAS OPH’s potential involvement in Ottawa area-based Ontario Health Teams may result in, as yet undefined, budgetary and/or governance implications for OPH;

THEREFORE BE IT RESOLVED that the Board of Health for the City of Ottawa Health Unit authorize Ottawa’s Medical Officer to Health to continue to explore this option, in collaboration with local partners, including the submission of self-assessments by the May 15, 2019 deadline;

AND BE IT FURTHER RESOLVED that the Medical Officer of Health report back to the Board of Health, either at the Board’s regular meeting of June 17, 2019 or at a Special Meeting, to be called by the Chair as needed, with respect to the outcome and/or with respect to any new information as of the date of said meeting.

The Board then heard from the following public delegations who talked about their partnerships with Ottawa Public Health and the importance of being able to retain that capacity going forward:

·         Norah Foster, Certified Credit Counsellor, Resolve Credit and Financial Counselling and member of the Ottawa Gambling Harms Prevention Network;

·         Marie-Josée Trépanier, Chair, Champlain Maternal Newborn Regional Program; and

·         Roberto Ortiz, Executive Director, and Brent Bauer, Chair, MAXOttawa.

After hearing the public delegations, Dr. Etches responded to questions from Members of the Board of Health. The Board then voted on motions 4/3 and 4/4, as noted below. The discussion on this item lasted approximately 95 minutes.

 

Motion 4/3

Moved by Vice-Chair DeGiovanni

WHEREAS the Provincial government’s 2019 Budget, released on April 11, 2019 announced some significant changes to how public health services in Ontario are structured, governed and funded;

AND WHEREAS there are many unknowns about how and when the Province proposes to implement these changes;

AND WHEREAS the Province is proposing to reduce the number of health units in Ontario from 35 locally-based health units to 10 regionally based health units;

AND WHEREAS local public health is known for its responsiveness to local needs, basing many of its programs and services on local evidence, data, and priorities;

AND WHEREAS the proposed restructuring is likely to result in a loss of local control and local responsiveness of public health programs and services;

THEREFORE BE IT RESOLVED that the Board of Health for the City of Ottawa Health Unit request that Ottawa City Council:

·         Request that the Mayor of Ottawa write to the Province of Ontario to communicate Council’s unequivocal support for the work of Ottawa Public Health;

·         Request the Province maintain the health protection, health promotion, and prevention mandate of Ottawa Public Health;

·         Request the Province maintain the current 75 percent provincial, 25 percent municipal funding formula for Ottawa Public Health and public health programs in Ontario; and

·         Request the Province initiate consultations with municipalities and public health agencies on the public health system in Ontario.

 

CARRIED

 

Motion 4/4

Moved by Vice-Chair DeGiovanni

WHEREAS on February 26, 2019, the Ministry of Health and Long-Term Care announced Ontario Health Teams as a new way of organizing and delivering services to patients;

AND WHEREAS on April 3, 2019, information was released with respect to the guidelines and process for applications for Ontario Health Teams;

AND WHEREAS Ottawa’s Medical Officer of Health has engaged in preliminary discussions with local partners to explore the possibility of Ottawa Public Health (OPH) becoming a partner in Ottawa area-based Ontario Health Teams;

AND WHEREAS the first step in this process is the submission of self-assessments, due to the Ministry by May 15, 2019, and the subsequent step will be for selected groups to be invited to submit their full applications by July 12, 2019, with Ontario Health Teams being announced beginning in the fall of 2019;

AND WHEREAS OPH’s potential involvement in Ottawa area-based Ontario Health Teams may result in, as yet undefined, budgetary and/or governance implications for OPH;

THEREFORE BE IT RESOLVED that the Board of Health for the City of Ottawa Health Unit authorize Ottawa’s Medical Officer to Health to continue to explore this option, in collaboration with local partners, including the submission of self-assessments by the May 15, 2019 deadline;

AND BE IT FURTHER RESOLVED that the Medical Officer of Health report back to the Board of Health, either at the Board’s regular meeting of June 17, 2019 or at a Special Meeting, to be called by the Chair as needed, with respect to the outcome and/or with respect to any new information as of the date of said meeting.

 

CARRIED

 

3.

OTTAWA PUBLIC HEALTH’S 2018 ANNUAL REPORT

 

ACS2019-OPH-BOH-0006

 

That the Board of Health for the City of Ottawa Health Unit:

1.        Receive Ottawa Public Health’s 2018 Annual Report; and

2.        Approve that it be forwarded to Ottawa City Council for information in accordance with the City of Ottawa Act, 1999.

 

CARRIED

 

At 6:48 p.m., the Board considered Motion 4/5, below.

Motion 4/5

Moved by Member El-Chantiry

BE IT RESOLVED THAT the Board of Health approve that the meeting time be extended past 7:00 p.m. pursuant to Subsection 8.(1)(c) of the Procedural By-law.

CARRIED

 

4.

DENTAL HEALTH SERVICES FOR LOW-INCOME SENIORS

 

ACS2019-OPH-HPP-0005

 

That the Board of Health for the City of Ottawa Health Unit:

1.         Receive, for information, a report on dental health services in Ottawa for low-income seniors; and

2.         Direct staff to request funding to support dental health services for low-income seniors if funding opportunities become available.

 

CARRIED

 

Ms. Esther Moghadam, Director of Health Promotion, spoke briefly to a PowerPoint presentation, which served to provide the Board with an overview of the report. She was accompanied by Nancy Kennedy, Program Manager, Dental Health Services, and Hoan Nguyen, Supervisor, Dental Clinical Operations. Following the presentation, staff responded to questions from Board members. This discussion lasted approximately 12 minutes. The Board then voted on the report recommendations.

 

5.

ONTARIO PUBLIC HEALTH STANDARDS – ACCOUNTABILITY AND PERFORMANCE REPORTING REQUIREMENT

 

ACS2019-OPH-KPQ-0001

 

That the Board of Health for the City of Ottawa Health Unit receive this report for information.

 

RECEIVED

 

6.

OTTAWA PUBLIC HEALTH EMERGENCY PREPAREDNESS AND RESPONSE

 

ACS2019-OPH-HPS-0001

 

That the Board of Health for the City of Ottawa Health Unit receive this report for information.

 

RECEIVED

 

7.

2018 OPERATING AND CAPITAL BUDGET YEAR-END RESULTS – BOARD OF HEALTH FOR THE CITY OF OTTAWA HEALTH UNIT STATUS REPORT

 

ACS2019-OPH-PCS-0002

 

That the Board of Health for the City of Ottawa Health Unit receive the 2018 operating budget year-end results for information.

 

RECEIVED

 

8.

DELEGATION OF AUTHORITY – CONTRACTS AWARDED FOR THE PERIOD OF JULY 1 TO DECEMBER 31, 2018

 

ACS2019-OPH-PCS-0003

 

That the Board of Health for the City of Ottawa Health Unit receive this report for information.

 

RECEIVED

 

9.

ATTENDANCE AT THE ASSOCIATION OF LOCAL PUBLIC HEALTH AGENCIES’ (alPHa) 2019 ANNUAL GENERAL MEETING AND CONFERENCE

 

ACS2019-OPH-BOH-0005

 

That the Board of Health for the City of Ottawa Health Unit approve the attendance of Chair Egli and Members Cloutier and Pinel at the Association of Local Public Health Agencies’ (alPHa) 2019 Annual General Meeting and Conference, to be held from June 9 to 11, 2019 in Kingston.

 

CARRIED, as amended by Motion 4/2

 

Motion 4/2

Moved by Member El-Chantiry

THEREFORE BE IT RESOLVED that the Board of Health approve that Member Pinel’s name be removed from the report recommendation and one additional member be added (name to be confirmed), and that the report be approved, as amended by this change.

 

CARRIED

 

MOTION TO ADOPT REPORTS

Motion 4/7

Moved by Member El-Chantiry

BE IT RESOLVED THAT the Chair of the Board of Health Verbal Report, the Medical Officer of Health Verbal Report, and the reports titled Ottawa Public Health 2018 Annual Report, Dental Health Services for Low-Income Seniors, Ontario Public Health Standards – Accountability and Reporting Requirements, Ottawa Public Health Emergency Preparedness and Response, 2018 Operating and Capital Budget Year-End Results – Board of Health for the City of Ottawa Health Unit Status Report, Delegation of Authority – Contracts Awarded for the Period of July 1 to December 31, 2018, and Attendance at the Association of Local Public Health Agencies’ (alPHa) 2019 Annual General Meeting and Conference, be received and adopted.

CARRIED

 

MOTIONS REQUIRING SUSPENSION OF THE RULES OF PROCEDURE

There were no motions requiring suspension of the rules.

 

NOTICES OF MOTION (FOR CONSIDERATION AT SUBSEQUENT MEETING)

There were no Notices of Motion (for consideration at a subsequent meeting).

 

CONFIRMATION BY-LAW

Motion 4/8

Moved by Member El-Chantiry

BE IT RESOLVED THAT Confirmation By-law no. 2019-3, a by-law of the Board of Health for the City of Ottawa Health Unit to confirm the proceedings of the Ottawa Board of Health at its meeting of April 15, 2019, be read and passed.

CARRIED

 

INQUIRIES

There were no inquiries.

 

ADJOURNMENT

The Board adjourned the meeting at 7:02 p.m.

 

NEXT MEETING

Regular Meeting

Monday, 17 June 2019 - 5:00 PM, Champlain Room, 110 Laurier Avenue West

_____________________________                    _____________________________

BOARD SECRETARY                                           BOARD CHAIR


Ottawa Board of Health Meeting
Notes for Chair Keith Egli’s Verbal Report
Monday, April 15, 2019

Good evening everyone, Bonsoir,

March 20 launch of 2 new have THAT talk videos

On March 20th, I had the pleasure of joining Dr. Etches and the OPH team to unveil the two new have THAT talk videos and an activity guide on mental health for newcomers and diverse populations. The two new videos are called

1) Are You New to Canada? and

2) Mental Health = Health.

These new resources are an expansion on the popular mental health awareness and stigma reduction video series called have THAT talk, which has received more than one million views to date on YouTube. These videos and guide were developed in collaboration with 13 community partners and based on feedback from the community, evidence and local population data. These tools recognize people’s experiences and the challenges of settling into a new country and acknowledge newcomers’ resilience as they adapt to their new home. The aim is to increase awareness of positive mental health, the negative impact of stigma within Ottawa’s newcomer and diverse communities and to highlight the importance of seeking help early. I was impressed by the knowledge and compassion of the Expert Panelists at the launch as well as the questions and support shown from our many community partners in attendance. I would like to thank OPH employees for this great initiative and the community partners for their collaboration and support.

OPH participation at summer events

Spring is in the air and we are heading into a busy summer event season. In preparation, OPH has reached out to all members of Council and local MPPs to identify opportunities to connect directly with members of their communities. OPH enjoys and values participating in community events as these allow employees to connect directly with residents, community partners and stakeholders to share important public health information. These events also allow OPH to gather valuable feedback, which helps inform the development of public health policy, programs & services.

alPHa 2019 fitness challenge – an invitation for BOH members to participate

Looking ahead, Members may have noticed that one of the Communication Items included in our Agenda package relates to the Association of Local Public Health Agencies (alPHa) Fitness Challenge for Boards of Health. The Challenge calls on all members of the Board to walk or wheel for 30 minutes in April or May. Though a group activity is recommended, the challenge can also be completed individually. Board Members attending the OPH All-Staff Meeting on May 28th have the opportunity to make it a group activity by taking a 30-minute walk together at the end of the day. Otherwise, I would encourage Board members to complete their 30-minute walk or bicycle ride individually and to report this activity to our Board Secretary, who will report our participation back to alPHa.

CTS funding

Finally, as you know, on March 29, the Ministry of Health and Long-Term Care announced that Ottawa Public Health was not one of the 15 approved Consumption and Treatment Services in Ontario.  In response to this announcement, on April 1st, Mayor Watson and I sent a joint letter to the Minister of Health and Long-Term Care expressing disappointment with the decision, stressing the need for continued funding and requesting reconsideration. The letter outlined OPH’s role in the community with respect to reducing the risks of infectious diseases and deaths and our work with partner agencies. It also referenced the more than 14 thousand visits to our Supervised Consumption site since its opening, which helped reduce the burden on the overall health system. 

On April 3, 2019, Mayor Watson, Dr. Etches and I met with the Honourable Ginette Petitpas Taylor, federal Minister of Health, to discuss options for interim support from the Government of Canada. This meeting was followed by a joint letter to the Minister asking for her consideration of a specific request for interim funding for OPH’s Consumption and Treatment Service.

Board of Health Members have been kept informed on these recent developments through regular email communications on March 29, April 1 and April 5.

For over 20 years, OPH has served and provided leadership in the community of Ottawa by reducing the risk of infectious diseases and deaths through the direct provision of harm reduction services as well as through the coordination of such services across agencies. As such, OPH has been a pioneer in delivering services to prevent the transmission of HIV, hepatitis C and other associated diseases and in linking clients to social and health services. The consumption and treatment services at 179 Clarence Street have been operating daily since September 26, 2017.

Though there are Consumption and Treatment services nearby that have been approved for provincial funding for the fiscal year 2019-2020, most notably the Shepherds of Good Hope/Inner City Health service, they have indicated that they are currently operating at full capacity. From an ethical perspective, OPH cannot cease delivery of these services to its current clients without at least providing for some transitionary period.

Since April 1, 2019, OPH has been continuing to provide these important, life-saving services through internal re-allocations at a cost of about $3000 per day. OPH also continues to be a leader in harm reduction. As public health professionals, and as advocates for compassion in the communities, OPH continues to work alongside community partners to ensure as many services as possible continue to be available to those who need them, when and where they need them.

If colleagues are in agreement, I would ask that you authorize me, as Chair of the Board, to take any further actions that may be necessary and appropriate to secure ongoing funding for Ottawa Public Health’s Consumption and Treatment Services, in collaboration with the Medical Officer of Health and/or other partners and stakeholders. Should ongoing funding not be secured, I will seek to secure bridge funding to allow OPH to transition its clients to other Consumption and Treatment Service clinics over a reasonable period of time. I will also commit to continuing to keep Board Members informed of any new developments on this matter.

That concludes my verbal report.

I would welcome a motion on the last point, as well as any questions or discussion.


 

Ottawa Board of Health Meeting
Notes for Dr. Vera Etches Verbal Report
Monday, April 15, 2019

Thank you Chair, and good evening, bonsoir, kwe everyone.

I would also like to begin by honoring Métis Elder Jo MacQuarrie, she was truly a remarkable person, we will continue to share her message and echo her passionate voice to promote reconciliation and address Indigenous health inequities. May she rest in peace.

In tonight’s verbal report, I will be focusing on the significant changes to Ontario’s public health system that were announced as part of the budget.

Before describing the specific announcements, I want to tell you why I chose to specialize in public health and preventive medicine and I want to highlight the core functions of the public health system. 

As a medical student and then family physician, I saw so many people, in clinics and emergency rooms, in hospital, who were there because they had failed to receive the supports that would keep them well.  I remember an older man who had not accessed care until his arthritis had made him almost unable to move – he did not know how to read and had suffered poor health because of it. I remember a mother, who was a newcomer, whose baby I caught and how isolated she was after the birth of her baby, unaware of the supports available for healthy growth and development.  These individual interactions are precious and important points of care, and, they showed me the need to create communities and a health system that prevents poor health.  After 14 years of work alongside the diverse professionals in the public health system, I am more convinced than ever that people need a strong public health system to be healthy, safe and well.

(Slide 1) There are five classic functions of the public health system, as shown on this slide.  I think of population health assessment first because that is like our diagnostic tool.  Epidemiologists use their skills to measure the health of the population and point us towards what interventions or treatments are necessary.

The next handful of slides provide examples of how we carry out the other public health functions here in Ottawa.   We work within the community, supporting people from before they are born through the end of life, with programming and service offerings that are most often delivered in partnership.

·         OPH assists families prenatally and with newborns so that they may get a good start in life. Created in partnership with CHEO, Our Parenting In Ottawa/Être parents à Ottawa website, is a resource for parenting right through the teen years and on this site people can learn more about connecting to a nurse on-line, options for telephone or chat support, and our most intensive support for parents, in-home visiting by public health nurses and home visitors with different cultural backgrounds, to which people can self-refer.  Screening of new parents, usually after the birth of a child, also identifies risk factors that trigger this additional support.  The PIO website is a resource for grandparents, also, to brush up on the latest evidence-based approaches to early childhood development.  For every $1 spent on early childhood development, the health care system saves up to $9 in future spending on health, social and justice services.

·         OPH reaches school aged children through health promotion activities and programs such as vision screening in school. Many school children are not benefitting from free optometrist eye exams and 3 to 5% are at risk of permanent vision loss each year in Ottawa.  Therefore, OPH is piloting screening 5 year olds in school and working with local optometrists to increase access to glasses as needed.

·         OPH provides immunization services to reduce the harms caused by infectious diseases. In addition to school-based immunizations, OPH has ventured into giving childhood and catch-up immunizations to populations with barriers to primary care, such as in shelters for families with unstable housing and for refugees, in partnership with the Centretown CHC and the YMCA.  Every $1 spent on immunizing children with the measles-mumps-rubella vaccine saves $16 in health care costs.

We see the need for this work in our City today, as this month OPH entered into an enhanced response to investigate two cases of measles in individuals who recently travelled internationally. These measles cases are not connected. OPH is working closely with local health care providers and hospitals to contact individuals and families who may have been exposed to the infectious case.

·         OPH engages youth and emerging adults, on their ground, through social media and online interactions. Health communications is a core function and channel for health promotion.  We have more followers on Twitter, 55,000+, than any other local public health organization in North America.  We have some great material for you to re-tweet.

·         OPH Engages in partnerships, such as with Inner City Health and Community Health Centres, to assist people with substance use issues to reduce the harms from substance use and find a pathway to treatment and reduction or cessation of use.  As the need to address opioid overdose continues, we are also focussing on the myths about cannabis and continuing to shine a light on the substance causing the greatest burden of illness after tobacco – alcohol.  Every $1 spent on mental health and addictions saves $7 in health costs and $30 dollars in lost productivity and social costs.

·         Speaking of tobacco, one of OPH’s roles is to promote and protect health through healthy public policies, and the City of Ottawa has been a leader around by-laws that create smoke-free spaces. Every $1 invested in tobacco prevention programs saves up to $20 in future health care costs.  Following Board support to engage the provincial and federal governments on the related subject of vaping, the Mayor, Chair and I had a chance to convey our concerns about promotion of vaping products to the provincial and federal Ministers of Health earlier this month.

Other public policy work that we engage in relates to advancing reconciliation with Indigenous communities. Municipal policy is a special focus, such as transportation policy.  In fact, the Official Plan that guides development in the City of Ottawa is currently in consultation and you have an opportunity to let Councillors know that building walkable, connected communities is important to you for the health of the population.

·         OPH also partners with the City of Ottawa as an active participant in city-wide emergency responses such as last fall’s tornado/power outage and the Westboro bus crash earlier this winter. That being said, we also work with partners to plan and prepare for emergencies – before they occur.

·         The LHIN has supported OPH’s work in partnership with the city Recreation Department to provide our growing population of seniors with fitness and wellness programs that includes falls prevention – the number one cause of injury-related emergency room visits and hospitalizations among older adults.

·         Lastly, OPH promotes mental health across the lifespan.  A resource for workplaces is the video series called “have THAT talk”, which is on YouTube and comes with facilitators’ guides that can be used by teams to promote mental health in the workplace.  Two new videos were just released this week to address the topic of mental health for newcomers and people from diverse backgrounds.

By ensuring that Ottawans get a healthy start, remain healthy, are able to quickly return to health and well-being at all ages, the public health system delivers value for money.

In an era where there is a greater focus on providing better, more timely and patient-centred care, the public health system more than carries its weight, making significant contributions to reducing the demands placed on hospitals and primary care providers.  Public health actions now result in fewer emergency room visits today, as well as the prevention of more visits tomorrow.

Moving now to the announcements in the budget last Thursday. (Slide 12)

·         In 2019–20:

o   Improve public health program and backoffice efficiency and sustainability while providing consistent, highquality services, be responsive to local circumstances

o   Adjust provincial–municipal costsharing of public health funding (currently about 75 provincial, 25 municipal)

o   Streamline the Ontario Agency for Health Protection and Promotion (Public Health Ontario) to enable greater flexibility with respect to noncritical standards based on community priorities

·         By 2020-21

o   Establish 10 regional public health entities and 10 new regional boards of health with one common governance model

o   Modernize Ontario’s public health laboratory system by developing a regional strategy to create greater efficiencies across the system and reduce the number of laboratories

o   Remove backoffice inefficiencies through digitizing and streamlining processes to ensure public health agencies focus their efforts on providing better, more efficient frontline care

·         By 2021-22:

o   Achieve annual savings of $200M by modernizing public health units through regionalization and governance changes to achieve economies of scale, streamlined backoffice functions and better coordinated action by public health units

§  The current provincial contribution for cost-shared programs is $750M, which leads to the figure of 27% of the funding being cut that has been discussed in the media.

The Ministry of Health and Long-Term Care has not yet communicated with the public health field about this budget direction.  There is not yet any information available about what this means specifically for Ottawa Public Health.

Slide 13 – There are many questions raised by the provincial budget.  Answers to these questions will be important to guide next steps.  While the direction to establish 10 regional public health agencies is clear, the timelines and process used for implementation are likely areas where we can influence.

Slide 14 - What I do know is that we will likely have to look at the priorities for how we spend our money, so I have included a couple of slides that remind us of the current breakdown of our budget.  Much of the school health funding actually goes towards provision of immunizations in schools.

Slide 15 – Most of our budget is for salaries, wages and benefits, so any reductions will most likely have implications for employees.

While the changes are significant and raise important concerns about maintaining capacity for carrying out core protection, promotion and prevention work, there are opportunities that could be realized with a regional approach.

Slide 16 – Previous reviews of the public health system after SARS led to recommendations that there be fewer health units in Ontario.  Larger health units have greater capacity for foundational standards like population health assessment, for recruitment and retention of skilled professionals, and are able to mobilize more quickly for urgent responses.  The province has indicated that savings could come with more collaboration on back-office practices, like purchasing, and digital processes.  Ottawa Public Health is very interested in initiatives that could involve electronic records, for instance.

Another key opportunity that is part of the evolving health system landscape in Ontario is that Ontario Health Teams are forming.  Ontario Health Teams are intended to focus on the coordination of care for patients and on improving their defined population’s health. I believe that there is a role for the participation of public health agencies, who can focus on prevention, protection and health promotion, informed by patient and community health needs.  I see a future where public health units can work with multiple OHTs, providing:

·         guidance on understanding the population in a geographic area to ensure that the teams understand the complex needs of the populations they serve;

·         capacity building and promoting supports, including environmental supports, that lead to chronic and infectious disease prevention, healthy living, substance use and injury prevention;

·         reach into the extensive networks that public health fosters - links with education, municipalities and others - that will facilitate community-based awareness and response to emerging health needs, with a focus on equity; and,

·         the planning and management expertise to support the prevention and control of communicable diseases and emergency responses that will not be restricted to the clients of any single Ontario Health Team.

OPH’s mission is to work together with our community to improve, promote and protect the health and well-being of the people of our city. I anticipate that participation as a member of the Ontario Health Teams that will form in Ottawa will help to achieve this mission, as well as aid with the objective of reducing the pressure on health care providers.  The capacity to carry out public health work could be strengthened within Ontario Health Teams.

Slide 17 – What is important to keep as a guiding principle is that the population’s health needs vary across the province and so flexibility for local adaptations to service provision is key.  Maintaining a way for municipalities to influence delivery of public health services is important, not only because elected officials represent the needs of their populations but also because many of the drivers of health are outside of the healthcare sector.  With a regional lens on public health programing, efforts need to be made to keep specific needs of Indigenous communities or Francophones as priorities.  As we move forward with implementation of 10 regional health units, the goal must be timely and quality public health services that prevent disease and injury for all now and into the future.

Slide 18 – This is a slide I use to highlight that not only are local municipalities partners, but so are local school board, social services, police and many others.

Lastly, the way forward…

Health is not just about the individual or healthcare, health is also about the communities in which we live and the social, political and economic policies that shape our environment.  As you can see in this slide, the social and built environments are much greater contributors to our overall health when compared to our biology and the health care we receive.

As I described the role of public health, I think you will be able to recognize that some of our interventions (like immunization and harm reduction) fall in the overlap between public health practice and the healthcare system, as depicted on this slide.  The public health sector also values the connections with municipal, education and other sectors, some of which I have mentioned, to address the determinants of health.  In order to improve the population’s health, capacity must be maintained to do the unique work of public health – initiatives focused on prevention, protection and health promotion.

Chair that concludes my verbal report. I am happy to answer any questions. Merci.

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