1. UPDATE ON PROVINCIAL
REVIEW OF PUBLIC HEALTH MANDATORY HEALTH PROGRAMS AND SERVICES GUIDELINES
(MHPSG) MISE À JOUR SUR LA RÉVISION PAR LA PROVINCE DES LIGNES
DIRECTRICES TOUCHANT LES PROGRAMMES ET SERVICES DE SANTÉ OBLIGATOIRES (LIGNES
DIRECTRICES) |
That
Council:
1. Approve the final consolidated response
to the draft Ontario Public Health Standards, as submitted to the Ministry of
Health and Long-Term Care Technical Review Committee, by Ottawa Public Health,
on March 9, 2007, on behalf of the City of Ottawa (see document 1).
2. Write to the
Minister of Health and Long-Term Care requesting a thorough review of the
provincial public health funding formula and it’s application, in order to
redress the inequitable per capita funding status with respect to Ottawa Public
Health.
Recommandation du Comité
Que le Conseil :
1. D’approuver la version
finale de la réponse globale aux normes provisoires de santé publique de
l’Ontario, qui a été soumise le 9 mars 2007 au Comité de révision
technique du ministère de la Santé et des Soins de longue durée par Santé
publique Ottawa au nom de la Ville d’Ottawa (voir le document 1);
2. D’envoyer au ministère de la Santé et
des Soins de longue durée une lettre lui demandant d’effectuer un examen
approfondi de la formule provinciale de financement de la santé publique et de
sa mise en application, en vue de remédier à l’iniquité du financement par
habitant à Santé publique Ottawa.
DOCUMENTATION
1.
Deputy City Manager report dated 26 March 2007 (ACS2007-CPS-HEA-0002).
Report
to/Rapport au :
Community and Protective Services Committee
Comité de la santé, des loisirs et
des services sociaux
and Council /et Conseil
Submitted by/Soumis par : Steve Kanellakos,
Deputy City Manager/Directeur municipal adjoint,
Community and Protective
Services/Services communautaires et de protection
Contact
Person/Personne ressource : Dr. David Salisbury, Medical Officer of Health /
Médecin chef en santé publique
Ottawa Public Health / Santé publique Ottawa
(613) 580-2424 x23681,
dave.salisbury@ottawa.ca
That the Community and
Protective Services Committee recommend that Council:
1. Approve the final consolidated response
to the draft Ontario Public Health Standards, as submitted to the Ministry of
Health and Long-Term Care Technical Review Committee, by Ottawa Public Health,
on March 9, 2007, on behalf of the City of Ottawa (see document 1).
2. Write to the
Minister of Health and Long-Term Care requesting a thorough review of the
provincial public health funding formula and it’s application, in order to
redress the inequitable per capita funding status with respect to Ottawa Public
Health.
Que le
Comité des services communautaires et de protection recommande au
Conseil :
1. D’approuver la version
finale de la réponse globale aux normes provisoires de santé publique de l’Ontario,
qui a été soumise le 9 mars 2007 au Comité de révision technique du
ministère de la Santé et des Soins de longue durée par Santé publique Ottawa au
nom de la Ville d’Ottawa (voir le document 1);
2. D’envoyer au ministère de la Santé et
des Soins de longue durée une lettre lui demandant d’effectuer un examen
approfondi de la formule provinciale de financement de la santé publique et de
sa mise en application, en vue de remédier à l’iniquité du financement par
habitant à Santé publique Ottawa.
Further to Community and Protective Services Committee direction (March 1, 2007), professional staff at Ottawa Public Health (OPH), working with Councillors Cullen and Feltmate, reviewed the draft Ontario Public Health Standards (OPHS) and submitted a response, within provincially dictated timelines. The survey tool, designed by the Ministry of Health and Long-Term Care (MOHLTC), called for a technical and detailed response which exceeds 300 pages. In short, the impression of staff at OPH is that while the draft OPHS represents an improvement over the current Mandatory Health Programs and Services Guidelines in several areas, on balance there are significant limitations.
En réponse à une directive du Comité des
services communautaires et de protection (donnée le 1er mars 2007),
des professionnels de Santé publique Ottawa (SPO), en collaboration avec les
conseillers Alex Cullen et Peggy Feltmate, ont examiné les normes provisoires
de santé publique de l’Ontario et fait part à la Province de leurs observations
à cet égard, dans les délais prescrits par cette dernière. Conformément à
l’outil d’évaluation conçu par le ministère de la Santé et des Soins de longue
durée de l’Ontario (MSSLD), la Province réclamait un document de rétroaction technique
et détaillé de plus de 300 pages. En gros, le personnel de SPO estime que
bien que les normes provisoires de santé publique constituent, dans plusieurs
domaines, une version améliorée des Lignes directrices touchant les programmes
et services de santé obligatoires, elles présentent d’importantes limites.
On March 1, 2007, Community and Protective Services Committee received the draft renewed Ontario Mandatory Health Programs and Services (now called the Ontario Public Health Standards (OPHS) and approved recommendations directing;
DISCUSSION
As directed by CPSC, Ottawa’s Medical Officer of Health forwarded a letter to Ontario’s Chief Medical Officer of Health on March 6, 2007, expressing concern about the short time allotted for the review of the renewed draft OPHS and requesting an extension (see document 2). A co-chair of the MOHLTC Technical Review Committee responded to this request on behalf of the Chief Medical Officer of Health, stating there would be no exception made to the consultation deadline (see document 3).
Notwithstanding this disappointing response, professional staff at Ottawa Public Health conducted as comprehensive and thorough a review of the draft OPHS as possible, given the time constraints. This review involved all levels of staff and management. Councillors Cullen and Feltmate provided invaluable assistance with the decision making required and a consolidated response was submitted to the MOHLTC Technical Review Committee within the allotted time (see document 1).
The Province’s consultation was
carried out using a web-based electronic survey, where respondents were asked
to rate their agreement with specific elements of each program standard on a
five point Likert scale. While there was space for comments and suggestions,
the use of this survey format limited the type of information collected. The
heavy focus on a rating scale and prompted responses restricted, somewhat, the
opportunity to provide more reflective and creative responses. Nevertheless, the consolidated response, as
submitted, included extensive comments on the quality and relevance of the
draft program standards, as well as detailed suggestions for revision. Overall
comments on the document in its entirety were also provided.
Significant limitations are noted. However, the
lack of protocols in this version of the draft standards makes it extremely
difficult to assess the impact of these proposed standards on local public health
practice. The standards, as presented, provide direction on “what” a local
board of health should do; however, there is no direction on “how” these
standards are to be implemented. Further, the proposed revisions appear to
significantly downplay attention to the social determinants of health and the
importance of ensuring equal access to services by disadvantaged or vulnerable
populations.
The proposed changes to the standards will
unquestionably necessitate a thorough review and re-alignment of business
practices. While it is difficult to accurately assess the resource requirements
implied by the proposed new OPHS in the absence of protocols, it appears
certain that they will not be revenue neutral. In fact, Ottawa Public Health
(OPH), like almost all other Health Units in Ontario, is not adequately
resourced, through the Ministry of Health and Long-Term Care (MOHLTC)
cost-sharing model, to be in full compliance with even the existing 1997
Mandatory Health Programs and Service Guidelines. Per capita provincial funding
for OPH is demonstrably the lowest amongst Public Health Units across the
province.
CONCLUSION
Ottawa Public Health professional staff, with the assistance of Councillors Cullen and Feltmate, have completed a review of the draft Ontario Public Health Standards and submitted a comprehensive response as part of the MOHLTC consultation process.
It is recommended that Community and Protective Services Committee approve this consolidated response and forward to Council for review and final approval; and that Community and Protective Services Committee recommend that Council convey it’s concerns to the MOHLTC with respect to funding inequities.
Not applicable
There are no financial implications for the recommendations
detailed above.
Document 1: Final consolidated response to the
draft Ontario Public Health Standards (previously distributed under separate
memorandum dated 21 March 2007)
Document 2: Letter to Ontario’s Chief Medical
Officer of Health dated March 6, 2007 (previously distributed and held on
file)
Document 3: Response from MOHLTC Technical
Review Committee on behalf of the Chief Medical Officer of Health dated March
7, 2007 (previously distributed and held on file)
Council will write to the Ministry of Health and Long-Term Care, affirming that this submission constitutes Ottawa Board of Health’s response to the provincial consultation on the draft Ontario Public Health Standards and noting profound concern with respect to provincial funding for public health in Ottawa.