1. Operation Health Protection: Local Public Health Capacity Review - An Overview - Dr. Susan Tamblyn, Chair ALPHA All-members Meeting April 22, 2005

2. 2 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

3. 3 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

4. 4 Public 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

5. 5 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

6. 6 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)

7. 7 CRC - Membership NameOrganization Susan Tamblyn (Chair)Former MOH, Perth District Health Unit (retired) Brian Hyndman (Vice- Chair) Toronto Board of Health, Citizen Representative Liana NolanCommissioner/MOH, Waterloo Regional Health Unit Diane BewickDirector, Family Health Services, Middlesex-London Health Unit Don WestDirector, Administrative Services, Porcupine Health Unit Lori G. Chow Director, Health Promotion and Chronic Disease Prevention Thunder Bay District Health Unit Alex MunterVisiting Professor, Faculty of Social Sciences, University of Ottawa Andrew PapadopoulosDirector, School of Occupational and Public Health Ryerson University Jane UnderwoodCo-Investigator/Consultant Nursing Health Services Research Unit, McMaster University Erica di RuggieroAssociate Director, Canadian Institutes of Health Research Institute of Population and Public Health Charles PascalSecretary to the Board & Executive Director Atkinson Charitable Foundation Terry HicksDental Consultant, Muskoka-Parry Sound Health Unit

8. 8 Guiding Principles for the Review Process Meaningful participation Recognize diversity Build on best practices Alignment and coordination Transparency in communication Sustainability

9. 9 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.

10. 10 Local 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-Ministry Working Group Planning Support

11. 11 CRC Sub-Committees: Governance and Structure Public Health Human Resources Public Health Funding Research and Knowledge Transfer Public Health System Accountabilities

12. 12 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

13. 13 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.

14. 14 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

15. 15 Research and Knowledge Transfer Sub-Committee Co-Chairs: Brian Hyndman and Jennifer Zelmer Deliverables: 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

16. 16 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

17. 17 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

18. 18 Methodology & Inputs for Local Public Health Capacity Review PHU Survey Commissioned research including OPHA Capacity Mapping Reference Panel / Round Tables Survey 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

19. 19 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

20. 20 Public Health Unit Survey Purpose: 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

21. 21 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

22. 22 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.

23. 23 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

24. 24 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

25. 25 Methodology & Inputs for Local Public Health Capacity Review PHU Survey Commissioned research including OPHA Capacity Mapping Reference Panel / Round Tables Survey 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

26. 26 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.caCapacityReview@moh.gov.on.ca Speaking engagements Updates on Ministry-MOH calls Formal strategy involving stakeholders and municipal representatives (already described)

27. 27 Questions and Comments?