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Dr. Sheela Basrur Chief Medical Officer of Health and

Public Health Division Presentation to Board of Health Section Association of Local Public Health Agencies (alPHa). Dr. Sheela Basrur Chief Medical Officer of Health and Assistant Deputy Minister, Public Health Division November 12, 2004.

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Dr. Sheela Basrur Chief Medical Officer of Health and

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  1. Public Health DivisionPresentation toBoard of Health SectionAssociation of Local Public Health Agencies (alPHa) Dr. Sheela Basrur Chief Medical Officer of Health and Assistant Deputy Minister, Public Health Division November 12, 2004

  2. “We will build a public health system that all Ontarians can have confidence in” Hon. George Smitherman - June 22, 2004

  3. Table of Contents Overview 2004 Allocation Other Initiatives 2005 and Beyond Questions

  4. Overview

  5. Public Health Reports Since SARS a number of reports have been produced that dealt with public health • October 21, 2003 - The Naylor Report outlined the need for a comprehensive, multi-year and multi-jurisdictional strategy to renew public health in Canada • December 20, 2004 - The interim report of the Walker Panel included 53 recommendations • April 20, 2004 - Justice Campbell’s Interim Report identified a number of areas requiring attention and further development to effectively deal with the challenges of emerging and infectious diseases like SARS. • April 21, 2004 - The final report of the Walker Panel with 103 recommendations • July 21, 2004 - The report of Justice Haines with 113 recommendations dealing with meat inspection and handling

  6. 2004 Ontario Budget The 2004 Ontario budget made the following commitments for public health: • $156M over 3 years to add three new, publicly funded vaccines. • Increased investment in public health to $273M in 2004-05, growing to $469M in 2007-08. • Increased provincial share of public health funding from 50% to 75% by 2007. • Creation of an independent public health agency to provide laboratory and epidemiological services to translate research and information into practical assistance, tools, advice and support to Ontario’s health care providers. • Continuation of the Universal Influenza Immunization Program • A smoke-free environment in work and public places within three years. • Promote increased participation in sports and physical activity, particularly for children, youth, and low-income individuals. • Investments in improved electronic service delivery including: public health information systems.

  7. Health Transformation Agenda • Building on the government commitments in the 2004 budget, the Ministry of Health & Long-Term Care is moving forward with its Transformation Agenda: • decreased wait times for key procedures and services • establishment of Local Health Integration Networks (LHINs) • major emphasis on healthy living and disease prevention • Key priorities related to public health include: • a revitalized public health system (Operation Health Protection); • a comprehensive child vaccination program; • reduced rates of tobacco use • reduced rates of childhood obesity; and • a health care system that lives within Ontario’s means

  8. Operation Health Protection On June 22, 2004, the Ministry released Operation Health Protection set out a clear plan for the future : • Increased provincial funding of public health units from 50% to 75% • Review the organization and capacity of health units • Review and update the Mandatory Health Programs and Services Guidelines - last updated in 1997 • Produce an annual Ontario Public Health Performance Report • Establish an Ontario Health Protection & Promotion Agency • Increased independence of the Chief Medical Officer of Health Phil Jackson, Director, Strategic Planning & Implementation Branch will provide more information on Operation Health Protection later this afternoon

  9. Independence of Chief Medical Officer of Health Bill amending the Health Protection and Promotion Act to increase the independence of the CMOH was introduced on October 14, 2004. Goals • Increase the independence of the Chief Medical Officer of Health (CMOH). • CMOH to issue an annual report on the health of Ontarians. Objectives • Ensure that the CMOH has the necessary legislative authority coupled with adequate protection to speak independently and publicly on important matters of public health. • Ensure that the CMOH has clear operational powers to address health risks. • Beginning in 2005/06 the CMOH will issue an annual report on the health of Ontarians.

  10. 2004 Allocation

  11. 2004 Transfer Payments • An announcement of the 2004 health unit allocation is imminent • Between 1999 and 2003 provincial support for local health units increased by $67.1M or almost 39% • This allocation includes funding for: • Mandatory Health Programs and Services • including Unorganized Areas • Public Health Research, Education & Development (PHRED) program • West Nile virus • Infection Control (100%) • Cash flow adjustments will begin with November 30th payment

  12. Other Initiatives

  13. Ontario Tobacco Strategy Scope: • Expanded OTS will target prevention, protection and cessation • MOHLTC will work in partnership with health units and other providers/groups Timeline: • Minister announced his intention to introduce new tobacco control legislation in the fall 2004 • Government commitment to 100% smoke free workplaces and public places within three years Planned Outcome: • Considering a range of smoking control measures, including: • prevention programs (especially among children and youth) • protection against second-hand smoke • quit smoking programs and supports

  14. Expansion of Children’s Immunization Program Scope: • As part of the Healthy Ontario strategy, the government committed $156 million to add three new vaccines (Meningococcal, Pneumococcal and Varicella) to the children's free immunization program in 2004-05 Timeline: • The first vaccines were made available in July, 2004 with the full program to be phased in over the next three years Planned Outcome: • The new vaccination programs will help reduce the devastating effects meningitis, severe infections and chicken pox can have on children and their families.

  15. Local Health Integration Networks Scope: • 14 LHINs located in communities across the province • Support planning, coordination, funding, resource allocation at the local level • Respect and support local governance of health delivery • Will not directly provide services Timeline: • Workshops will be held in each LHIN area starting November 19th • Initial LHIN Board meetings planned for April 2005 Planned Outcome: • Shift of some authority from Queen’s Park to communities • Funding and resources more effectively organized along geographic and referral lines to meet the needs of those receiving health care • Role of health units to be determined

  16. 2005 and Beyond

  17. Accountability • To ensure that services provided by health units respond effectively to the needs of Ontarians, the Ministry is undertaking a number of initiatives: • program-based budgeting system as noted in the previous slide • program specific performance measures • consistent with other government initiatives/programs • based on Mandatory Health Programs and Services Guidelines • public health performance report, as mentioned earlier as part of Operation Health Protection • will build on above initiative • first report expected December, 2005 • The Ministry will work with health units to further develop and refine these accountability mechanisms to meet the needs of the government, the Ministry, health units and the public

  18. Cost-Share Shift The government has committed to increase the provincial cost-share for Mandatory Health Programs & Services to 75% by 2007 Effective January 1, 2005 health units can expect the approved “stepped increase” to 55% Implications: • intent to increase overall investment in public health in order to meet public health needs and comply with mandatory programs. • may impact on the municipal financial burden, depending on the extent to which municipalities maintain current funding levels

  19. 2005 Transfer Payments • 2005 transfer payment allocation guidelines to be released early in New Year • 2004 experience • clear definitions of eligible expenses • 2005 program-based budget process will: • support enhanced review, analysis and increased focus on accountability • align with, and begin to incorporate performance data captured as part of performance measurement system • allow more comprehensive and focussed analysis of future budget requests

  20. Questions

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