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Meeting of the Board of Health for the Porcupine Health Unit

Held on April 25, 2019, Timmins Office, Board Room

Present:

  • Sue Perras
  • Drago Stefanic
  • Sebastien Lessard
  • Pat Britton
  • George Pirie
  • Marc Ringuette
  • Rock Whissell

Staff:

  • Dr. Lianne Catton
  • Don West
  • Maria Cook
  • Lynn Leggett
  • Joëlle Aubin
  • Anna Gauthier
  • Sue Lajoie
  • Chantal Riopel

Recorder:  Maria Cook


1. Call to Order

Sue Perras, Chair, 5:00 p.m.

2. Approval of Agenda

MOVED BY: Marc Ringuette
SECONDED BY: Sebastien Lessard

THAT the agenda for this meeting be approved as amended.

Carried

3. Adoption of Minutes of Meeting

MOVED BY: Drago Stefanic
SECONDED BY: Pat Britton

THAT the minutes of the meeting of the Board of Health for the Porcupine Health Unit held March 22, 2019 be approved.

Carried

4. Business Arising from Minutes

None.

5. Correspondence

Dr. Lianne Catton spoke to the following correspondence:

Toronto – City Clerk’s Office

Re: Toronto Indigenous Overdose Strategy

Copy of email, dated March 27th, to Prime Minister Trudeau, Premier Doug Ford, and Minister Christine Elliott advising of their Board’s resolution, noting the following:

  • Endorse Toronto Indigenous Overdose Strategy, dated February 6th, from the Medical Officer of Health
  • Urge the Government of Canada and Province of Ontario to fund and support the development of Indigenous-led overdose prevention and response action plans at the federal and provincial levels.
  • Urge the federal and provincial governments to:
    • align 2019/2020 (and beyond. funding calls with practical and immediate overdose responses, with access to funding supports for Indigenous agencies to create, strengthen, and enhance culturally-safe outreach, mobile, and peer support services to Indigenous Peoples who use substances; and
    • to contribute funding to Toronto Public Health's Toronto Urban Health Fund Indigenous Stream, to support Indigenous agencies; and to enhance support to Indigenous-specific programs and services in mainstream organizations to expand their outreach and harm reduction capacity.
  • Urge the Ministry of Health and Long-Term Care to:
    • dedicate funding for 24/7 Indigenous-led Consumption and Treatment Services in Toronto, as part of the new Consumption and Treatment Services Program;
    • ensure the availability of culturally-safe medical care to Indigenous Peoples who use substances now and into the future, explore opportunities to support the use of traditional medicines and approaches to healing, for their Indigenous clients;
    • require all provincially-funded health care providers that provide medical services to Indigenous Peoples, in Toronto, to demonstrate accountability through formal mandates and strategic plans for their investments and outcomes related to culturally-safe care for Indigenous Peoples, including ongoing Indigenous cultural-safety training and education for non-Indigenous health care providers; and
    • increase and target funding to support the development and operationalization of culturally-safe, appropriate, and on-demand abstinence-based treatment spaces for Indigenous Peoples
  • Direct the Medical Officer of Health to provide a one-year progress report on the implementation of the Toronto Indigenous Overdose Strategy to the Board of Health and the Toronto Indigenous Health Advisory Circle in 2020 and;
  • That Michelle Sault, Principal Consultant, Minokaw Consulting, make a presentation on the Toronto Indigenous Overdose Strategy, at a future Board of Health meeting, in 2019.

Perth District Health Unit

Re: Strengthening SFOA, 2017

Copy of letter, dated April 2nd, to Premier Doug Ford, supporting Renfrew County and District Health Unit’s correspondence regarding strengthening the Smoke-Free Ontario Act, 2017 to address the promotion of vaping.

Peterborough Pubic Health

Re: Bill 60 (An Act to amend the Ministry of Community & Social Services Act to establish the Social Assistance Research Commission)

Copy of letter, dated April 3rd, to Ministers Lisa MacLeod and Christine Elliot, supporting North Bay Parry Sound District Health Unit’s call for the establishment of the Social Assistance Research Commission (SARC) and urging the passing of Bill 60 as an important step towards fiscal responsibility for health care costs and to address health inequities associated with food insecurity.

Southwestern Public Health

Re: Vision Screening Funding Request

Copy of letter, dated April 3rd, to Minister Christine Elliott, requesting additional funding be provided to implement the new vision screening program within schools.

Peterborough Public Health

Re: Funding for the Healthy Babies, Healthy Children (HBHC) Program

Copy of letter, dated April 3rd, to Minister Lisa MacLeod, supporting correspondence from Thunder Bay District Health Unit, and sharing their concern and the concern of other local public health agencies regarding the HBHC program funding, advocating that the Ministry of Children, Community and Social services fully fund the HBHC program including all staffing, operating and administrative costs.

6. Medical Officer of Health Report

Dr. Lianne Catton, Medical Officer of Health, provided an update/report with regard to the following:

Cultural Mindfulness

As cultural mindfulness is a core component of the Porcupine Health Unit (PHU) Reconciliation Framework, and priority two of the PHU 2018-2023 Strategic Plan, all staff will complete an online course, offered by the Ontario Indigenous Cultural Safety (ICS) Program. There are seats reserved for Board of Health (BOH) members as well and this will be discussed further at a future meeting. Additionally, several staff members and the PHU BOH Chair were fortunate to attend a Cultural Mindfulness session with George Couchie. The session was offered by the Timmins and District Hospital, and the PHU provided the space for two full day sessions for community partners. It was an extremely informative and poignant day that was greatly appreciated, and is so important in the work we do.

Organizational Change

The organizational change is well underway with the development of the new Foundations Team led by Chantal Riopel to increase capacity, efficiency, consistency and accountability. This includes quality assurance and professional standards, health equity, communications, epidemiology as well as program planning. It will be even more important to have this team in place with potential budget cuts and regionalization. As part of this change, the Healthy Growth and Development team is moving to the Chronic Disease and Injury Prevention team to create a health promotion team that addresses the lifespan. As a result of these changes there will be some movement of staff in the Timmins offices in order to have the new teams together.

Locally Driven Collaborative Project

The PHU has been a partner with the four other Northeastern Health Units, Laurentian University, and Indigenous partners on a research project funded by Public Health Ontario.
This research project was to explore “mutually beneficial, respectful and effective principles and practices of engagement between First Nations communities and public health units in Northeastern Ontario can be identified, as an important step in working toward improved opportunities for health for all”.

The project included a literature review; survey of heath units who engage with First Nations communities; key informant interviews with Indigenous organizations, and focus group sharing with three First Nation Communities. Dr. Catton recently attended a meeting with the project team and Indigenous Circle in Sudbury. The project has been a tremendously positive experience, demonstrating the opportunity to increase capacity by working together, and will greatly inform ongoing Indigenous engagement for the PHU.

Local Ontario Health Teams (OHT)

With the announcement, the PHU is working with local hospitals, primary care, and community partners to participate in the Ontario Health Team Self-Assessment readiness tool to be submitted to the Ministry by May 15, 2019. While the application is being led by Timmins and District Hospital, several partner organizations cover the PHU region, and other area hospitals are also included.

Northeast (NE) Public Health Unit Collaborative Project

This project originally began to explore opportunities to collaborate to increase capacity for quality public health programs and services in the NE. With the recent announcements the project focus has shifted to consider potential recommendations for the regional public health system in the NE. A project manager has been hired. While the regions have yet to be determined, it is expected that the five NE health units will be together.

Public Health Transformation

Dr. Catton provided a presentation regarding the proposed changes to Ontario’s Public Health System. This includes a change in the number of public health units from 35 to 10 larger regional entities; and a change in funding with an increase in the municipal share, with cost sharing set at 70:30 provincial:municipal, effective April 1, 2019. The critical role of public health including but not limited to water and food safety, infectious disease prevention and control, prevention of chronic disease and injuries, advocacy, policy support, and emergency planning was discussed. Connections with municipalities and local community partners is integral to a strong public health system, and ensuring the presence of the local voice will be increasingly important going forward. On a positive note, the Ministry has made a commitment to funding a Seniors’ Low-income dental program, with details expected in the next few weeks.

Community Safety and Well-Being Plans

The PHU has been invited to participate on the Advisory Panel for the Township of Hornepayne and will be included in the City of Timmins as well. The PHU recognizes the tremendous linkages between safety, the built environment, and community development. With local population health data, and expertise in health equity and the social determinants of heath, the PHU hopes to play a role in the development of these plans in all communities

Opioid Crisis

The PHU area has unfortunately continued to engage with community partners with a need for increased local opioid surveillance in response to recent noted increased in suspected opioid related overdoses. While we continue to work upstream to prevent substance use, and it is preferable to not see surges in opioid related events in our communities, the Local
Opioid Surveillance and Response Task Force data collection and communication system worked well to flag an increase and respond.

While the events occurred in Timmins, the alerts and communications were distributed throughout all PHU communities, through emergency departments, healthcare providers, partner organizations, and shelters. They were also provided on PHU branch office doors, in French and English, and through the website and social media channels. School boards were also notified and information was provided to support conversations with children and adolescents. Increased outreach in the community, and to local shelters such as Living Space, occurred after hours to increase access to naloxone, the life saving medication that can reverse an overdose. We continue to advocate with the Ministry for innovative opportunities to address challenges unique to our area to expand access to naloxone.

Program Manager Reports

The Program Managers provided brief verbal reports with respect to their Program areas.

7. Resource Committee Report

Staff Changes

MOVED BY: Rock Whissell
SECONDED BY: George Pirie

THAT the report of staff changes be received for information.

Carried

Revenues & Expenditures – Year Ended December 31, 2018

MOVED BY: Rock Whissell
SECONDED BY: Marc Ringuette

THAT the report of revenues and expenditures for the Porcupine Health Unit for the year ended December 31, 2018 be approved.

Carried

2018 Audited Financial Statements

MOVED BY: Pat Britton
SECONDED BY: George Pirie

THAT the audited financial statements for the Porcupine Health Unit for the year ended December 31, 2018 be approved.

Carried

MOVED BY:Rock Whissell
SECONDED BY:George Pirie

THAT the audited financial statements for the Porcupine Health Unit Building Trust for the year ended December 31, 2018 be approved.

Carried

8. New Business

The Porcupine Health Unit in Context of Public Health Transformation – Dr. Catton

Dr. Catton summarized a presentation made to the Board of Health (BOH) regarding the recent public health announcements in Ontario. This includes a move from 35 public health units to 10 larger regional public health entities by 2020-2021. It has been announced these will be autonomous Boards of Health with Municipal and Provincial representation, however the details of the BOH composition is currently unknown. The regions have not been identified, and Legislative changes are expected in the Fall.

The Ministry has committed to a Low-income Senior’s dental program, with more details to follow. Dental services for low-income adults has been a longstanding concern for the PHU, and as such this is a positive addition for local public health.

Funding implications announced with the Ontario budget were also reviewed. There is a plan for $200 million in annual provincial savings by 2021-2022, to be achieved through regionalization and modified funding model with increased municipal share. The regionalization seeks to find efficiencies, centralize evidence-based functions, and improve consistency, recruitment, capacity. It is expected to better align with the Ontario Health Agency, local health teams, and Public Health Ontario (PHO). Maintaining local public health presence and strong local connections is critical, and this has been recognized by the Ministry. Details regarding timelines and specific changes remain unknown.

The changes in cost sharing with greater municipal share is proposed as follows:

  • Cost Sharing 2019 (as of April 1, 2019):
    • 60% - 40 % Toronto
    • 70% - 30% all others
  • Cost Sharing 2020:
    • 60% - 40 % Toronto
    • 70% - 30% all others
  • Cost Sharing 2021-2022:
    • 50% - 50 % Toronto
    • 60% - 40% 6 larger regional
    • 70% - 30% 3 smaller regional

While many details are unknown the PHU team continues to work with community partners to address our strategic priorities and ensure the public health standards are addressed. We are committed to ensuring the local voice of our unique and distinct communities are represented throughout these changes and in the future state of public health in the Northeast.

MOVED BY: Drago Stefanic
SECONDED BY: George Pirie

WHEREAS, the Board of Health of the Porcupine Health Unit (PHU) recognizes the critical role of local public health in the overall health and well-being of the entire PHU population; and

WHEREAS, the recent budget release announcing the regionalization of the current 35 health units in Ontario to 10 larger, regional entities; with an expected annual savings of $200 million by 2021-2022 through this regionalization, as well as changes to the funding model with increased municipal share; and

WHEREAS, the Porcupine Health Unit is dedicated to the promotion and protection of health in the largest geographical area of all health units, with diverse communities including Francophone and Indigenous populations; and

WHEREAS, unique inequities and challenges contribute to the consistently higher rates of poor health outcomes of the PHU population compared to the rest of Ontario; and

WHEREAS, the local voice, connections and priorities are critical for the ongoing comprehensive public health approach to address the public health standards as well as local priorities; and

WHEREAS, the Board of Health for the Porcupine Health Unit remains committed to being a partner in transformation for a strong effective public health system; and

WHEREAS, the proposed regionalization raises concerns regarding the loss of this local public health voice and connections;

NOW THEREFORE BE IT RESOLVED that the Ministry of Health and Long-Term Care (MOHLTC) and the Province of Ontario allow for extensive engagement with the field and local public health expertise to ensure that the core functions and strengths of the public health system are maintained with significant consideration for maintenance of a strong local public health presence and representation; and

FURTHERMORE, BE IT RESOLVED THAT, a copy of this resolution be forwarded to the Honourable Christine Elliott, Deputy Premier of Ontario and Minister of Health and Long-Term Care, and Dr. David Williams, Chief Medical Officer of Health for the Ministry of Health and Long-Term Care, Association of Local Public Health Agencies, Porcupine Health Unit member municipalities and Ontario Boards of Health.

Carried

9. Receipt of Minutes for Information

Program Committee Meeting Minutes

MOVED BY: Marc Ringuette
SECONDED BY: Drago Stefanic

THAT the minutes of the Program Committee meeting held November 2, 2018
be received for information.

Carried

Management Committee Meeting Minutes

MOVED BY: Pat Britton
SECONDED BY: Sebastien Lessard

THAT the minutes of the Management Committee meeting held February 5, 2019
be received for information.

Carried

10. Date of Next Meeting and Adjournment

MOVED BY: George Pirie
SECONDED BY: Sebastien Lessard

THAT the next meeting of the Board of Health for the Porcupine Health Unit be held on May 23, 2019 at 5:00 pm and that this meeting adjourn.

Carried