Agency Implementation Task Force Final Report From Vision to Action: A plan for the Ontario Agency for Health Protection and Promotion Presentation for: APHEO May 12, 2006

2 Background High profile reports recommended the creation of a public health agency for Ontario Naylor Report (Oct’03)Walker Interim Report (Dec’03) Justice Campbell’s 1 st Report (Apr’04) Justice Campbell’s 2 nd Report (Dec ‘04) Walker SARS Expert Panel Report (Apr’04)Justice Haine’s Report (Jul’04) Walker Legionnaire’s Panel Report (Dec’05)CMOH 2005 Annual Report (Jan’06) Government committed to establish a public health agency for Ontario Operation Health Protection: An Action Plan to Prevent Threats to our Health and to Promote a Healthy Ontario released on June 22, 2004

3 Agency Implementation Task Force – Mandate In early 2005, Agency Implementation Task Force struck to advise the Chief Medical Officer of Health (CMOH): Validate Agency’s mandate, key functions, structure, governance and oversight; Recommend operational public health responsibilities for the Agency, and delineate its role and responsibilities in relation to the government, academia, broader public health system; and Recommend a comprehensive three-year implementation plan for the Agency. Co-Chaired by Dr. Geoff Dunkley and Dr. Terry Sullivan 14 members - provincial or national experts in research, laboratory services, infectious diseases and a range of other disciplines (Appendix 1) Part One Report released in October 2005 Final Report released March 20, 2006

4 Part One Report – Conceptual Framework for Agency

5 Final Report Forward looking and visionary Recommends the Agency name “Ontario Agency for Health Protection and Promotion” Builds on the Part One Report and provides greater detail on the proposed Agency’s: Governance and Accountability Ministry/Inter-Ministry Liaison Organisational Design Legislative Authority Ontario Public Health Laboratories Support in Emergency and Exigent Circumstances Phasing-in (priorities)

6 Key Directions and Recommendations Maintaining the Momentum Establish a dedicated transition support group Creating the Agency Establish through special purpose legislation Scheduled agency of the Crown Collect, use and disclose data in a privacy-sensitive manner Governance and Leadership Arm’s length from the government Board of Directors appointed through Order in Council (OIC): Initial board (5-7) and full board (13) Based upon skill-mix not organizational/sectoral affiliation Standing Committees of the Board Board selects and hires CEO

Key Directions and Recommendations cont’d Governance Strategic Planning Scientific Advisory Audit Standing Committees Agency Board CMOH / ADM Minister of Health and Long-Term Care CEO Public Health Division Chair Minister of Health Promotion CMOH Functional Relationships - Working Relationship with CEO - Sits on Strategic Planning Committee - Activates Agency participation in times of emergency or exigent circumstances - Non-voting Board member Government

8 AREAS OF SPECIALISATION CLIENTS FUNCTIONS Key Directions and Recommendations cont’d Public Health Units Health Care Providers Partner Ministries Surveillance and epidemiology Research Knowledge exchange Laboratory services Professional development Communication Infectious disease and infection prevention and control Health promotion, chronic disease and injury prevention Environmental health Emergency and Exigent Circumstances Support in

9 Key Directions and Recommendations cont’d Funding Multi-year funding (at least $45M + labs) Hold 3 rd party funds Access supplementary funds in emergency/exigent circumstances Accountability Memorandum of Understanding (MOU) Reporting (Annual Report submitted to the Minister for tabling in the Legislature) Working with Partners MOHLTC to coordinate process for other ministries to work with the Agency Agreements to formalize partnerships with ministries/organisations Research and Knowledge Exchange Province-wide network for research, training and knowledge exchange 3-year research agenda for public health

10 Key Directions and Recommendations cont’d CMOH Roles Formal liaison between Agency and ministries Ensure establishment of Inter- and Intra-Ministry Committees to set provincial priorities for the Agency Attend Board meetings (no vote) Member of Strategic Planning Committee of the Board Activate Agency involvement in emergency or urgent circumstances Proposed Government Roles Core corporate and stewardship functions for Public Health retained by MOHLTC including: Policy and Legislative Development Ensure compliance and accountability with standards and guidelines Public Health HR planning, assessment and training Emergency management activities General health communication to practitioners, professionals, public and media Fund public health units and health care facilities and ensure accountability Maintain direct relationships with federal departments except when delegated to the Agency

11 Key Directions and Recommendations cont’d Proposed Government & Agency Roles in an Emergency Overall lead is Emergency Management Ontario MOHLTC leads health components through existing structure Communication to stakeholders resides with leading ministry Agency functions as activated within overall framework (at initiation of CMOH/EEMC) Strengthen and Align Ontario Public Health Laboratories Proceed in line with operational review recommendations Co-locate core Central Public Health Laboratories functions with the Agency Restructured Ontario Public Health Laboratories with advanced testing Phased Transition Plan and Lab Transition Team (coordinate move, information system, manage HR support) – full transition goal 2008

12 Task Force Key Messages on Final Report Release The report contains the AITF’s best advice on the design and implementation of a public health agency for Ontario, which the AITF recommends be named the “Ontario Agency for Health Protection and Promotion”. It is a simple concept: the creation of a specialised body, distinct from the overall planning, policy, funding and oversight functions that form ministries. The Agency would be a smaller focussed body whose primary function and mandate is the science, research and knowledge to better anticipate, understand and provide scientific and technical guidance on threats to our health in an objective and organised manner. Last October, when the task force presented its first report, they proposed a mandate, vision, mission, core values and conceptual framework for the Agency. With its final report, the AITF sets out a detailed governance structure and the necessary links to ministries and local public health units and re-affirmed the need for the province to move forward quickly.

13 Task Force Key Messages on Final Report Release The vision set out, however, is not about filling holes exposed by SARS; it is about the belief that, with political will and the right organization, Ontario can have, within a few short years, an organization that is internationally recognized for excellence. Therefore the AITF recommends that the Agency be established by special purpose legislation as a scheduled agency of the Crown, governed by an independent board of directors with the Minister of Health and Long Term Care accountable for the expenditures of the agency to the Legislature. The AITF sees the Agency better linking the research and surveillance activities underway in distinct silos. The Agency will play a vital bridging role as an organised scientific hub, better coordinating our knowledge and laboratory- based surveillance through the public health laboratory system. The AITF sees the Ontario’s Chief Medical Officer of Health serving as a strong link between provincial ministries and the Agency, and playing a key role in ensuring provincial and regional input to priority setting and strategic planning for the Agency.

14 Summary - Opportunities for Associations with Agency Caveat - Based on Report Recommendations subject to government approval Participate on Standing Committees of the Board such as: Strategic Planning; Scientific; and Audit Assist Agency to develop: province-wide network for research, training and knowledge exchange; and 3-year research agenda Provide field input into development of Agency’s strategic plan Support Agency functions: Research Knowledge Exchange Professional Development Enter into partnerships for specific initiatives Note, projects above strategic plan would need supplementary resources

15 Opportunities for Associations with the Agency cont’d Agency Strategic Planning Committee - reviews input from Ministry Committees - recommends Strategic Plan for Board Approval Agency Board of Directors - approves Strategic Plan Agency Strategic Plan Approved - provided to MOHLTC through an annual business plan - implemented by Agency Intra-Ministry Committee - identifies MOHLTC priorities for Agency consideration Field Input through surveys, regular for a and needs analysis: - Public Health Units - Organisations - RICNs - Etc. Inter-Ministry Committee - identifies Ministries priorities for Agency consideration Task Force recommended approach for the Agency to develop their Strategic Plan

16 Appendix 1 – Task Force Membership NameTitle & Organization Dr. Geoff Dunkley (Co-Chair)Former Associate MOH, Ottawa Public Health Unit Dr. Terry Sullivan (Co-Chair)President and CEO, Cancer Care Ontario Ms. Jennifer ZelmerVice President of Research and Analytical Services, CIHI Dr. Andrew SimorHead, Department of Medical Microbiology Sunnybrook and Women’s Health Sciences Centre Ms. Mae Katt RN(EC) Nurse Practitioner, Anishnawbe Mushkiki Thunder Bay Aboriginal Community Health Centre Dr. Alan MeekProfessor, Ontario Veterinary College, University of Guelph Mr. Ron YamadaA Founder and Executive Vice-president, MDS Inc. Dr. Linda O'Brien-PallasProfessor, Faculty of Nursing, University of Toronto Dr. Michael ChristianFellow, Infectious Disease and Critical Care Medicine, McMaster University Mr. Ken DeanePresident and CEO, St. Joseph’s Health Centre Dr. Donald ColeAssociate Professor, Public Health Services, U of T Dr. David L. MowatDirector General, Centre for Surveillance Coordination Public Health Agency of Canada Ms. Ruth SandersonHealth Unit Epidemiologist, Middlesex-London Health Unit Dr. Penny SutcliffeMOH/Chief Executive Officer, Sudbury & District Health Unit

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