Public Health Sector Strategic Plan Update to alPHa board

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

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. 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) 3

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

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.

6. A Plan Built on Partnerships: The Unique Position of the Sector Public Health Sector Please note that the Venn diagram is not meant to list all partners/organizations. Those included are identified as examples. Determinants of health – social, economic, environmental

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.

8. Public Health Sector Strategic Plan Framework Our Values Excellence, Preparedness, Collaboration, Equity, Accountability 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 Our Strategic Goals Optimize healthy human development Improve the prevention and control of infectious diseases Improve health by reducing preventable diseases and injuries Promote healthy environments – both natural and built Strengthen the public health sector’s capacity, infrastructure, and emergency preparedness Our Collective Areas of Focus Early childhood development, including mental wellness and resiliency Immunization Physical activity and healthy eating; tobacco and alcohol Built environment Information and knowledge systems; collaborative mechanisms; a highly competent workforce 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

9. OUR PROPOSED ACTIONS OUR STRATEGIC GOALS Strengthen the public health sector’s capacity, infrastructure, and emergency preparedness Promote healthy environments, both natural and built Improve health through reducingpreventable diseases and injuries Optimize healthy human development Improve the prevention and control of infectious diseases OUR COLLECTIVE AREAS OF FOCUS Information & Knowledge SystemsSector CollaborativeMechanismsHighlyCompetent Workforce Built Environment Physical Activity & Healthy EatingTobacco & Alcohol Early ChildhoodDevelopment, including mental wellness and resiliency Immunization 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. Scope Definition; Capacity Building, and Evidence Generation. Preventive strategies to attain healthy weights; Reduce tobacco use; Reduce alcohol misuse; Including accessing priority populations. 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. Implement Immunization Review findings; Evaluate and renew Universal Influenza Immunization Program (UIIP); Consider and prioritize new vaccines for public funding.

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 OUR STRATEGIC GOALS OUR COLLECTIVE AREAS OF FOCUS OUR PROPOSED ACTIONS Current Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.) Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.) Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.) Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.) Outcomes Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.) 3-5 year metrics (established as sector) 3-5 year metrics (established as sector) 3-5 year metrics (established as sector) 3-5 year metrics (established as sector) 3-5 year metrics (established as sector) 3-5 years 15-20 years 15-20 year metrics – population outcomes 15-20 year metrics – population outcomes 15-20 year metrics – population outcomes 15-20 year metrics – population outcomes 15-20 year metrics – population outcomes Evidence Informed through continuous research, evaluation, best practices and quality improvement processes

11. Implementation • 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. Discussion & Questions • 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?