Operation Health Protection:Local Public Health Capacity Review

- An Overview -

Dr. Susan Tamblyn, ChairALPHA All-members Meeting

April 22, 2005

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Objective of Presentation

• To provide:

• the context for the formation of the Local Public Health Capacity Review

• an overview of the goals, objectives and processes associated with the review

• an opportunity for questions and feedback regarding the process

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Call for Public Health Renewal: Key Reports

• January 2002 – Walkerton Report

• October 2003 – Naylor Report on SARS

• April 2004 – Justice Campbell’s first Interim Report

• April 2004 – Final Report of the Walker Panel

• July 2004 –Justice Haines’ report on meat inspection

• November 2004 – Standing Committee on Justice Policy report on Bill 138 (emergency response)

• April 2005 – Second Interim Report from Justice Campbell

4Public Health Renewal – Local Public Health Capacity Review

Capacity Review Committee (CRC) • struck January 2005 as part of Operation Health

Protection• CRC mandate is to advise on options to improve the

function and configuration of the local public health unit system

• reports to Chief Medical Officer of Health• interim report due early summer; final report

December 2005

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CRC Terms of Reference CRC will advise the CMOH, and through her, MOHLTC on

options to improve the function and configuration of the local Public Health Unit system. The advice to be provided encompasses the following:

• Core capacities required at the local level to meet communities’ specific needs and to effectively provide public health services

• Issues related to recruitment, retention, education and professional development of public health professionals in key disciplines

• Operational, governance and systemic issues that may impede the delivery of public health programs and services

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• Mechanisms to improve systems and programmatic and financial accountability

• Strengthening compliance with the Health Protection and Promotion Act, associated regulations and the Mandatory Health Programs and Services Guidelines

• Organizational models for public health units that optimize alignment with the configuration and functions of the LHINs, primary care reform and municipal funding partners

• Staffing requirements and potential operating and transitional costs

CRC - Terms of Reference (cont’d)

7CRC - MembershipName Organization

Susan Tamblyn (Chair) Former MOH, Perth District Health Unit (retired)

Brian Hyndman (Vice-Chair)

Toronto Board of Health, Citizen Representative

Liana Nolan Commissioner/MOH, Waterloo Regional Health Unit

Diane Bewick Director, Family Health Services, Middlesex-London Health Unit

Don West Director, Administrative Services, Porcupine Health Unit

Lori G. Chow

Director, Health Promotion and Chronic Disease PreventionThunder Bay District Health Unit

Alex Munter Visiting Professor, Faculty of Social Sciences, University of Ottawa

Andrew Papadopoulos Director, School of Occupational and Public HealthRyerson University

Jane Underwood Co-Investigator/ConsultantNursing Health Services Research Unit, McMaster University

Erica di Ruggiero Associate Director, Canadian Institutes of Health ResearchInstitute of Population and Public Health

Charles Pascal Secretary to the Board & Executive DirectorAtkinson Charitable Foundation

Terry Hicks Dental Consultant, Muskoka-Parry Sound Health Unit

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Guiding Principles for the Review Process

• Meaningful participation

• Recognize diversity

• Build on best practices

• Alignment and coordination

• Transparency in communication

• Sustainability

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Committee Progress• First CRC meeting held in Toronto on January 24-25,

2005 to discuss the approach to the review and the overall work plan.

• Follow up meetings in March and April; 3 more scheduled before end of June.

• A work plan has been developed and five sub-committees have been established and have met.

• First meeting with reference panel held on April 11.

10Local Public Health Capacity Review – Overview of Process

Capacity Review Committee (CRC)

Reference Panel

Chief Medical Officer of Health

Sub-Committees

Roundtables

Public Health Human Resources

Public Health Funding

Knowledge and Research Transfer

Public Health System Accountabilities

Governance & Structure

Stakeholder Input

Strategic Planning and Implementation

Branch (SPIB)

Intra-MinistryWorking Group

Planning Support

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CRC Sub-Committees:

• Governance and Structure

• Public Health Human Resources

• Public Health Funding

• Research and Knowledge Transfer

• Public Health System Accountabilities

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Governance and Structure Sub-Committee Chair: Alex Munter

Deliverables:

• Recommendations for sustainable governance and structure of Ontario public health units, having regard to the diverse needs of local communities and stakeholders.

• Recommendations on the optimal configuration of the public health system in Ontario, with regard to factors such as funding, partnerships, shared services agreements and/or health unit consolidation, in order to maximize the efficient use of system resources

• Best practices for effective, accountable public health governance

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Public Health Human Resources Sub-Committee

Chair: Diane Bewick

Deliverables:

• A map of the public health human resource landscape including systemic gaps and future forecasting regarding core public health human resource needs.

• Sustainable recruitment, retention, and skills enhancement strategies that provide for an increased and sustainable supply of skilled public health professionals.

• Strategies to promote public health careers in Ontario

• A set of leadership skills for public health professionals.

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Public Health Funding Sub-Committee

Chair: Liana Nolan

Deliverables:

• Modernized, evidence based approach to public health funding in Ontario

• Transparent allocation mechanisms• Modernized and needs-based allocation

methodology• Funding approach and methodology that is planned,

appropriate and responsive to community needs

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Research and Knowledge Transfer Sub-CommitteeCo-Chairs: Brian Hyndman and Jennifer ZelmerDeliverables:

• Lessons learned from other models (eg PHRED, BC, Quebec)

• Assessment of gaps and analysis of needs

• Environmental scan and assessment of other key sources of research and knowledge transfer

• Recommendations for appropriate mandates and structure for a research and knowledge transfer system, including the potential role of the Health Protection and Promotion Agency, that support and enable more effective public health programs and policies and are anchored in public health needs.

• Joint committee with Agency Task Force

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Public Health System Accountabilities Sub-Committee

Chair: Lori Chow

Deliverables:

• Recommendations on accountability mechanisms and practices for individual health units and the public health system as a whole.

• These recommendations to have regard for the following key stakeholders: • local boards of health• obligated municipalities • Public Health Division • other ministries funding public health programs and services• the public

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Opportunities for Stakeholder Input - Phase 1 (Spring 2005)

• OPHA Capacity Mapping (completed)

• Public Health Unit Survey

• Public Health Unit Staff Survey

• Reference panel survey

• Municipal engagement

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Methodology & Inputs for Local Public Health Capacity Review

PHU Survey

Commissioned research including OPHA Capacity Mapping

Reference Panel / Round TablesSurvey in Phase I / Phase II only

FINAL REPORT

End of Dec. 2005

INTERIM REPORT

Mid-July

2005

Focus groups

Interviews

CRC & its Sub-committees

All-staff survey

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Association Capacity Mapping(conducted by OPHA)

Purpose:

• To gather information about selected HR issues in Ontario’s public health system by surveying OPHA constituent societies

• topics included association and membership profiles, education, professional development needs

• addressing capacity issues, gaps and potential solutions

• results will help inform next steps for CRC

Timeline: already completed; report in preparation

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Public Health Unit SurveyPurpose:

• To gather baseline data and initial feedback from all public health units on the 5 key areas of the capacity review:

• Public health human resources

• Governance and structure

• Research & knowledge transfer

• Public health system accountabilities

• Funding

• Survey designed to gather feedback from the public health unit “as a whole”

Timeline: spring 2005

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Public Health Unit Staff Survey

Purpose :• Provide forum for staff input outside of official

health unit response• Surface issues and strategies early in the process to

aid design of interview and focus group protocols• Maximize involvement and transparency of process

Timeline: spring 2005

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Reference Panel: Terms of Reference

Purpose:• Provide a forum to update public health practitioners /

associations on the activities of the CRC.• Provide a forum for public health practitioners /

associations to share their knowledge and expertise relating to public health and issues that emerge from the Local Public Health Capacity Review.

• Provide feedback to the CRC on specific matters which require a system-wide perspective.

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Municipal Engagement

Purpose:• Provide a forum to update municipal stakeholders on the activities of the CRC

• Provide a mechanism for municipalities to provide input

Participants:• Association of Municipalities of Ontario (AMO)• City of Toronto

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Opportunities for Stakeholder Input - Phase 2 (fall 2005)

• Focus groups and interviews with public health units and other key stakeholders

• Roundtables to engage experts on key areas of interest

• Reference Panel meetings

• Continued municipal engagement

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Methodology & Inputs for Local Public Health Capacity Review

PHU Survey

Commissioned research including OPHA Capacity Mapping

Reference Panel / Round TablesSurvey in Phase I / Phase II only

FINAL REPORT

End of Dec. 2005

INTERIM REPORT

Mid-July

2005

Focus groups

Interviews

CRC & its Sub-committees

All-staff survey

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Communication Plans

• Operation Health Protection newsletter (coming soon) • Web site

http://www.health.gov.on.ca/english/providers/project/ohp/crc_mn.html

• e-mail contact - CapacityReview@moh.gov.on.ca• Speaking engagements• Updates on Ministry-MOH calls• Formal strategy involving stakeholders and municipal

representatives (already described)

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Questions and Comments?