Future Directions for Public Health in Ontario

1. Future Directions for Public Health in Ontario Association of Nursing Directors and Supervisors in Official Health Agencies in Ontario (ANDSOOHA) October 5, 2005 Dr. Sheela Basrur Chief Medical Officer of Health and Assistant Deputy Minister, Public Health Division

2. Context for Change Rebuilding Public Health Capacity

3. The Plan to Rebuild Ontario’sPublic Health Division Today 1. Constructing the foundation – a new senior management structure 2. Roughing in the rooms – clarifying the branches and key areas of responsibility Tomorrow 3. Finishing the rooms – structure, processes, culture Rebuilding Public Health Capacity

4. Public Health Senior Management Structure Rebuilding Public Health Capacity

5. 5 Emergency Management Branch • Provides provincial leadership for the development, implementation and management of emergencies with a PH component: • Specialized public health emergency preparedness plans (e.g. pandemic influenza / avian flu, bioterrorism, smallpox, nuclear…) • Centralized advice and direction to Public Health Units on the development of emergency preparedness and contingency plans • Leads the Ministry’s operational response to an emergency and aligns provincial health response with local, federal, broader provincial public sector responses: • Establishes and manages MOU between MOHLTC and Public Health Units for effective deployment of staff during public health emergencies • Manages divisional emergency services including Public Health Call Centre and surge capacity • Contingency and business continuity plans for the Ministry of Health

6. 6 Infectious Diseases Branch • Provides provincial leadership and oversight in the prevention and control of infectious disease in Ontario through surveillance, policy and legislation, technical expertise, programs, outbreak management, evaluation and research. • Enhances the capacity of local public health system and health service providers to prevent and control infectious diseases through: • Surveillance and epidemiology services • Expert advice on prevention, surveillance and control measures (PIDAC) • Clearinghouse for program-specific information and research • Centralized development of plans, policies and program materials • Centralized program management in specific program areas (e.g. UIIP) • Program consultants who share expertise with Public Health Units • Provincial coordination and management of cross-jurisdictional infectious disease outbreaks • Collaboration and coordination with other jurisdictions across Canada and across the U.S. border

7. 7 Environmental Health Branch • Provides provincial leadership from a human health perspective on environmental policy and related issues (air quality/climate change, drinking water protection, land use and sprawl management, cleaner energy sources, etc.) including: • A long-term environmental surveillance program with short-term initiatives • Partnerships with key federal, provincial and municipal government agencies • Clearinghouse for program-specific information and research • Centralized development of plans, policies and program materials including risk assessment and toxicology frameworks • Centralized program management in specified program areas • Enhances the capacity of local public health system to carry out the legal duties of PHI’s and MOH’s to investigate, prevent, eliminate and reduce the human health impacts arising from environmental hazards

8. 8 Chronic Disease Prevention & Health Promotion Branch • Provides provincial leadership and oversight in the prevention of chronic disease and injuries through surveillance, policy and legislation, technical expertise, programs, and evaluation and research. • Enhances the capacity of local public health and health service providers to prevent disease and promote health, including: • Tobacco use prevention & cessation • Promotion of healthy weights through better nutrition and greater physical activity (esp. Active 2010 strategy) • Mental health and addictions, including problem gambling • Injury prevention • Further development of the mandate and key areas of responsibility for is Branch will be guided by the strategic objectives and mandate of the new Ministry of Health Promotion.

9. 9 Capacity Review & Implementation Branch • Contributes to Public Health Renewal through: • Support to the Capacity Review Committee (following transition planning) • Strategic management of CRC recommendations, including: • Amendments to the Health Protection and Promotion Act and Regulations • Public health human resources strategy • Public health accountability • Good governance by Boards of Health • Provincial approach to funding • Strategic research, policy and planning support for implementation of the Capacity Review Committee recommendations

10. 10 Public Health Standards Branch • Contributes to the renewal of public health by framing a strategic direction for public health programs and services in Ontario which: • is future-oriented • is reflected in evidence-based, results-driven program standards • forms the basis of our accountability relationship with public health service providers. • Strategic research, policy and planning support for Review of Mandatory Health Programs and Services Guidelines, in consultation with internal and external specialists, including: • Strategic management of Review recommendations • Development of standards and their implementation, including policy and legislative reform, and communication with stakeholders • Divisional lead for continuous improvement of program standards

11. 11 Strategic Planning & Implementation Branch • Divisional lead for: • looking ahead strategically • achieving alignment with stakeholder goals and priorities, government policy commitments and corporate directions. • Provides leadership to development and implementation of key strategic initiatives, including: • Agency Implementation Task Force (AITF) • Annual Ontario Public Health Performance Report • Divisional planning and priority setting • Divisional research, policy and planning support • Advice and counsel on divisional policy initiatives and submissions • Policy support to PH-related F/P/T and Aboriginal health initiatives

12. 12 PHIIT Strategy Office • Ensures that Ontario’s public health system has the information systems required to support programs and services, with communication, collaborative decision-making and systematic data-sharing wherever required • Aligns Information and Information Technology governance with local, provincial and pan-Canadian goals: • strategic planning • integration and rationalization of policies, architectures, business models, best practices, quality assurance, standards and access control • Provides strategic and secretariat support for the Public Health e-Health Council (PHeHC), with linkages to Ontario e-Health Office and initiatives • Develops and implements new I&IT development projects from a program perspective: • iPHIS (Integrated Public Health Information System) • Public health portal (for knowledge management and timely communication with internal and external stakeholders) • Immunization system • Inspection system • Provides leadership on business process improvement

13. 13 Controllership & Resources Management Branch • Establishes overarching performance management framework and services to drive continuous improvement within division and public health system. • Measurement of public health program performance • Assessment of compliance with standards • Facilitates effective and accessible communication and knowledge transfer with key internal and external stakeholders to ensure effective partnerships. • Ensures consistently applied operations and financial practices, processes and controls to manage our resources responsibly. • Operational support policy, services and oversight: procurement, records, assets, facility, human resources, freedom of information • Support to internal and external stakeholders, including issues management and communications

14. Recent Improvements • Tools • Enhanced access to scientific resources and research expertise • Electronic and print journals available to all staff • More functional work environments • Hardware/softgrades upgrades • Improved records management • Compensation review underway… • Recruitment +++, now & into the future! Rebuilding Public Health Capacity

15. Challenges / Opportunities Ministry of Health Promotion Health Protection & Promotion Agency Independent Reports of the Chief MOH

16. Ministry Program components being transferred to the Ministry of Health Promotion Mandatory Programs* Child Health (includes Children in Need of Treatment -- a dental health treatment and referral program for high risk schools and high risk children) • Chronic Disease Prevention • Injury Prevention, including Substance Abuse Prevention • Reproductive Health Health Promotion and Disease Prevention • Smoke Free Ontario Strategy • Healthy Weights Strategy • Ontario Heart Health Program • Ontario Stroke Strategy (Public Awareness Program) • Alcohol Education/Prevention (FOCUS) • Ontario Health Promotion Resource System • Effective Drug Use by Seniors • Osteoporosis Strategy (Public awareness program) • Low Birth Weight

17. Ministry Program components being transferred to the Ministry of Health Promotion Community and Mental Health Addiction • Problem Gambling Prevention Communciations • Health Promotion/Prevention Communications Services Injury Prevention Healthy Living • These programs all support the new ministry's mandate to coordinate programs that contribute to healthy living and wellness.

18. What’s in Store…. “Issue du jour” Creating MHP First Annual CMOHReport to the Legislature Commitment toRebuild Public Health StakeholderPressure Election 2007 Fiscal Restraint And Economic Prosperity Aboriginal Health LHIN’s and FHT’s Rebuilding Public Health Capacity

19. Conclusion “While we stop to think, we often miss our opportunity.” - Publilius Syrus (1st century B.C.)

20. Let’s work together to rebuild Public Health! Thank you.