1. Public Health Sector Strategic Plan Update to alPHa board April, 2013

2. 2 Purpose To provide an update on the Public Health Sector Strategic Plan since it was presented at the alPHa Winter Forum in February, and released at TOPHC To share preliminary thinking on implementation and next steps

3. 3 Context Significant strides have been made to renew Ontario’s public health system in the after- math of key events including Walkerton and SARS: Operation Health Protection, released in 2004, articulated the government’s strategic approach to renewal of public health and included key commitments related to: Emergency management; infection control and communicable disease capacity, including the creation of Public Health Ontario, and public health sector health human resources The final report of the Capacity Review Committee also made recommendations related to sector renewal and capacity development Key achievements have included: Establishment of Public Health Ontario (PHO); new Ontario Public Health Standards; new public health organizational standards; first ever accountability agreements and performance indicators with boards of health, and initiation of a review of provincial funding for public health The issues and policy environment has continued to change and evolve A Strategic Plan is required to leverage gains made and to continue to move the yard-stick in collective areas of focus The Plan was released on April 4, 2013 as a Chief Medical Officer of Health (CMOH) Special Report, at the Ontario Public Health Convention (TOPHC)

4. Strategic Plan for the Public Health Sector The Plan: Articulates a long term vision with short term, renewable, collective areas of focus Addresses gaps in sector infrastructure and capacity Addresses complex/emerging issues Will transform current activities related to the established “core” business of public health, coalesce resources across the sector, and engage others outside of the sector, as needed Makes the “case” for public health and links public health more clearly to broader health care sector reform, and activities of the non ‐ health sectors, to improve the health of the population 4

5. Strategic Plan for the Public Health Sector (cont’d) The plan is intended to articulate a long-term vision but to also identify collective areas of focus over the next 3-5 years. The Plan is framed within context of what we are already doing; including gaps in current efforts, emerging issues, and what the evidence is telling us: We have made considerable progress in renewing the public health sector in Ontario, and considerable gains in health which must be maintained. We need a plan to (1) address gaps in sector infrastructure and capacity; (2) make an impact on wicked/emerging issues; and, (3) transform current activities related to the established, “core” business of public health (i.e., coalesce resources of the sector and outside of it). The Plan is intended to be relevant and appropriate within the current statutory, policy, fiscal, accountability, and programmatic landscape. 5

6. A Plan Built on Partnerships: The Unique Position of the Sector 6 Determinants of health – social, economic, environmental Please note that the Venn diagram is not meant to list all partners/organizations. Those included are identified as examples. Non-Health Sector Partners Local government Provincial ministries Federal departments Broader public sector Private sector Education sector, including Colleges and Universities First Nations Aboriginal Groups Health Sector Partners Primary care Community care Acute care Long-term care Professional, and other, associations Non-governmental organizations Health Canada, Public Health Agency of Canada First Nations Aboriginal Groups Public Health Sector

7. Engagement of Aboriginal and First Nations Organizations The unique needs of Aboriginal and First Nations communities are recognized in the Plan approach and we intend to invite representatives to be involved in the implementation planning phase of the work The Ministry has committed to a separate but parallel process for First Nations communities under the Public Health Working Group of TFNHSOC, that is articulated in its Project Charter. Now that the report has been released it will be taken back to the Public Health Working Group of TFNHSOC and to the Health Coordination Unit at COO for further discussion, and to seek advice on how to engage First Nations communities throughout implementation. Further discussions will be held with the off-reserve organizations to seek advice on how to engage the off-reserve Aboriginal communities in the next phase of work. This includes proposed implementation tables, and other mechanisms, which are currently under discussion. 7

8. Public Health Sector Strategic Plan Framework Our Vision Ontarians are the healthiest people in the world supported by the best public health system in the world Our Mission To protect and promote the health of all people in Ontario through the delivery of quality public health programs and services, effective partnerships and a focus on health equity Improve the prevention and control of infectious diseases Strengthen the public health sector’s capacity, infrastructure, and emergency preparedness Improve health by reducing preventable diseases and injuries Optimize healthy human development Promote healthy environments – both natural and built Our Strategic Goals ImmunizationInformation and knowledge systems; collaborative mechanisms; a highly competent workforce Physical activity and healthy eating; tobacco and alcohol Early childhood development, including mental wellness and resiliency Built environment Our Collective Areas of Focus Our Approach A population health and life course approach that addresses the determinants of health and health inequity, and the needs of vulnerable populations, including Aboriginal populations. March 14 Our Values Excellence, Preparedness, Collaboration, Equity, Accountability

9. 9 OUR PROPOSED ACTIONS OUR STRATEGIC GOALS OUR COLLECTIVE AREAS OF FOCUS Promote healthy environments, both natural and built Promote healthy environments, both natural and built Built Environment Scope Definition; Capacity Building, and Evidence Generation. Scope Definition; Capacity Building, and Evidence Generation. Optimize healthy human development Early Childhood Development, including mental wellness and resiliency Early Childhood Development, including mental wellness and resiliency Build on current initiatives including HBHC and other government strategies; Integrate evidence to support early childhood development and maternal/child/youth health, and mental wellness and resiliency. Build on current initiatives including HBHC and other government strategies; Integrate evidence to support early childhood development and maternal/child/youth health, and mental wellness and resiliency. Improve health through reducing preventable diseases and injuries Improve health through reducing preventable diseases and injuries Physical Activity & Healthy Eating Tobacco & Alcohol Preventive strategies to attain healthy weights; Reduce tobacco use; Reduce alcohol misuse; Including accessing priority populations. Preventive strategies to attain healthy weights; Reduce tobacco use; Reduce alcohol misuse; Including accessing priority populations. Improve the prevention and control of infectious diseases Immunization Implement Immunization Review findings; Evaluate and renew Universal Influenza Immunization Program (UIIP); Consider and prioritize new vaccines for public funding. Implement Immunization Review findings; Evaluate and renew Universal Influenza Immunization Program (UIIP); Consider and prioritize new vaccines for public funding. Strengthen the public health sector’s capacity, infrastructure, and emergency preparedness Strengthen the public health sector’s capacity, infrastructure, and emergency preparedness Information & Knowledge Systems Sector Collaborative Mechanisms Highly Competent Workforce Implement Panorama; Develop I&IT Strategy; Develop Surveillance Strategy; Partnerships with Health sector; Enhance partnerships with other Sectors; Create formal mechanism for Public Health evidence to policy; Public Health HR and workforce development strategy. Implement Panorama; Develop I&IT Strategy; Develop Surveillance Strategy; Partnerships with Health sector; Enhance partnerships with other Sectors; Create formal mechanism for Public Health evidence to policy; Public Health HR and workforce development strategy.

10. 10 Identifying Outcomes and Indicators We will review current metrics We will identify desired population outcomes, and develop metrics for the Plan Work will be informed by existing Accountability Agreements and indicators, and will also consider the 2011 CMOH Annual Report Outcomes Current Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.) 3-5 years 3-5 year metrics (established as sector) OUR STRATEGIC GOALS OUR COLLECTIVE AREAS OF FOCUS OUR PROPOSED ACTIONS 15-20 year metrics – population outcomes 15-20 years Evidence Informed through continuous research, evaluation, best practices and quality improvement processes

11. Implementation 11 Since the Plan’s release we have sought advice and direction from PHLC regarding next steps We are considering key milestones and processes, going forward This will include: Continued engagement of government and local-level partners to further socialize the plan and to build broader buy-in Work to comprehensively inventory existing initiatives at the provincial and local levels that can be leveraged to support implementation [e.g. the Healthy Kids’ Panel Report, Open Minds, Healthy Minds] Regional sessions - We will be asking Public Health Units if they will consider hosting these sessions which may also include other local partners The establishment of implementation tables with provincial and local-level membership A detailed implementation plan/strategy – to be completed by December 2013

12. Do you have any advice regarding implementation approaches? What is your advice regarding optimal engagement of alPHa, boards of health, and PHUs? Do you have advice regarding prioritization of implementation approaches? 12 Discussion & Questions