10.
Provincial
Review of Public Health Mandatory Health Programs and Services Guidelines
(MHPSG)
EXAMEN
PROVINCIAL DES LIGNES DIRECTRICES SUR LES PROGRAMMES ET SERVICES DE SANTÉ
OBLIGATOIRES
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COMMITTEE
RECOMMENDATIONS
That Council:
1. rReceive
the draft
renewed Ontario Mandatory Health Programs and Services (now called the Ontario
Public Health Standards), attached as Document 1, for information.
2. dDirect Ottawa
Public Health to compile feedback on the draft Ontario Public Health Standards
and submit it
to the Ministry of Health and Long Term Care Technical Review Committee (TRC)
as the response from the City of Ottawa, pending final Council approval at its
meeting of April 11, 2007.
3. dDirect
Ottawa Public Health staff to report back to Community and
Protective Services Committee and Council with the final compiled results on
the draft Public Health Standards, for final approval.
RecommandationS du Comité
Que le
conseil:
1. de
recevoir la version provisoire des programmes et services de santé obligatoires
de l’Ontario renouvelés (maintenant connus sous le nom de Normes de santé
publique de l’Ontario), jointe à titre d’information sous le nom
Document 1;
2. de
demander à Santé publique Ottawa de compiler les commentaires sur la version
provisoire des
Normes de santé publique de l’Ontario et de les faire parvenir au Comité
d’examen technique du ministère de la Santé et des Soins de longue durée à
titre de réponse de la part de la Ville d’Ottawa, en attendant l’approbation
finale par le Conseil lors de
sa réunion du 11 avril 2007;
3. de
demander au personnel de Santé publique Ottawa de rendre compte au Comité des
services communautaires et de protection et au Conseil des résultats définitifs
compilés sur la version provisoire des Normes de santé publique pour
approbation finale.
For the information of
Council
1. Recommendation
2 of the attached report has been removed from the list of recommendations that
require Council’s consideration. The
recommendation became redundant when the Ministry rejected a previously written
request from the City’s Medical Officer of Health to extend the deadline for
comments, from 9 March to 30 April. Dr.
Salisbury’s letter to the Ministry of Health and Long Term Care (MOHLTC) and the
response were previously circulated to members of the Community and Protective
Services Committee and are attached.
2. Councillor
Cullen and Councillor Feltmate were nominated to work with a subcommittee of
staff to develop the City’s response to the Ontario Public Health Standards,
which will report back to the Community and Protective Services Committee on
April 5th.
Pour la gouverne du Conseil
1.
La
recommandation 2 du rapport ci-joint a été retirée de la liste des
recommandations nécessitant l’examen du Conseil municipal. Elle est devenue redondante
après le rejet par le Ministère d’une demande écrite du médecin chef en santé
publique de la Ville visant à repousser du 9 mars au 30 avril la date
limite pour la présentation de commentaires.
La lettre du Dr Salisbury au ministère de la Santé et
des Soins de longue durée ainsi que la réponse ont été préalablement
distribuées aux membres du Comité des services communautaires et de protection
et sont jointes au présent document.
2. Le conseiller Cullen et la conseillère
Feltmate ont été désignés pour participer aux travaux d’un sous-comité du
personnel chargé de rédiger la réponse de la Ville aux normes de santé publique
de l’Ontario, qui fera rapport au Comité des services communautaires et de
protection le 5 avril.
DOCUMENTATION
1.
Deputy City Manager report dated 22 February 2007 (ACS2007-CPS-HEA-0001).
2. Extract of Draft Minutes, 1 March 2007.
3. Medical Officer of Health letter dated
6 March 2007.
4. Director, Public Health Standards
Branch, MOHLTC letter dated 9 March 2007.
Report to/Rapport
au:
Community and Protective Services Committee
Comité des services communautaires
et de protection
and Council / et au Conseil
22 February 2007 / le 22 février 2007
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
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Ref N°: ACS2007-CPS-HEA-0001
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SUBJECT:
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Provincial Review of Public
Health Mandatory Health Programs and Services Guidelines (MHPSG)
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OBJET :
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EXAMEN PROVINCIAL DES LIGNES DIRECTRICES SUR LES PROGRAMMES ET SERVICES DE SANTÉ
OBLIGATOIRES
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REPORT RECOMMENDATIONS
That Community and Protective
Services Committee recommend that Council:
1. rReceive
the draft
renewed Ontario Mandatory Health Programs and Services (now called the Ontario
Public Health Standards), attached as Document 1, for information.
2.
Recommend
that the City fforward
a letter to the Ministry of Health and Long Term Care requesting that the
consultation period be extended in order to allow for input from members of the
board of health (ie Members of Council).
3.
dDirect Ottawa
Public Health to compile feedback on the draft Ontario Public Health Standards
and submit it to the Ministry of Health and Long Term Care Technical Review
Committee (TRC) as the response from the
City of Ottawa, pending final Council approval at its meeting of April 11,
2007.
4. dDirect
Ottawa Public Health staff to report back to Community and Protective Services
Committee and Council with the final compiled results on the draft Public
Health Standards,
for final approval.
C.
RECOMMANDATIONS
DU RAPPORT
Que le
Comité des services communautaires et de protection recommande au conseil:
1. de
recevoir la version provisoire des programmes et services de santé obligatoires
de l’Ontario renouvelés (maintenant
connus sous le nom de Normes de santé publique de l’Ontario), jointe à titre
d’information sous le nom Document 1;
2. de
faire parvenir une lettre au ministère de la Santé et des Soins de longue durée
dans laquelle il demande que la période de consultation
soit prolongée afin de permettre aux membres du conseil de la santé de faire
part de leurs commentaires (c.‑à‑d. les
membres du Conseil);
3. de
demander à Santé publique Ottawa de compiler les commentaires sur la version
provisoire des Normes de
santé publique de l’Ontario et de les faire parvenir au Comité d’examen
technique du ministère de la Santé et des Soins de longue durée à titre de
réponse de la part de la Ville d’Ottawa, en attendant l’approbation finale par
le Conseil lors de sa réunion
du 11 avril 2007;
4.
de
demander au personnel de Santé publique Ottawa de rendre compte au Comité des
services communautaires et de protection et au Conseil des résultats définitifs
compilés sur la version provisoire des Normes de santé publique pour approbation
finale.
EXECUTIVE SUMMARY
The MHPSG) are provincial standards that set out
the minimum requirements of Boards of
Health to provide public health programs and services targeted at disease
prevention, health promotion and health protection. The current standards were
promulgated in 1997. In 2004 the Ministry of Health and Long Term Care (MOHLTC)
committed to initiating a review of the Mandatory Health Programs and Services
Guidelines. Work commenced in 2006.
A revised draft
MHPSG document has now been produced by the MOHLTC and has been re-named Ontario Public Health Standards. It was
released for consultation to local boards of health and approximately 80
interest groups on February 19, 2007. Each board of health is requested to
provide a single, consolidated response to the consultation through an
electronic poll by March 9, 2007.
A strategy for
responding to this consultation is proposed.
RÉSUMÉ
RÉSUMÉ
Les lignes directrices sur les programmes et
services de santé obligatoires sont en fait des normes provinciales qui
précisent les exigences minimales des conseils de santé quant à la prestation
de programmes et de services de santé publique qui visent à prévenir les
maladies et à promouvoir et à protéger la santé. Les normes actuelles ont été
promulguées en 1997. En 2004, le ministère de la Santé et des Soins de longue
durée (MSSLD) s’est engagé à entreprendre un examen des lignes directrices sur
les programmes et services de santé obligatoires. Les travaux à cet égard ont
commencé en 2006.
Le
MSSLD a maintenant produit une version révisée du document provisoire des
lignes directrices sur les programmes et services de santé obligatoires, lequel
a été renommé Normes de santé publique de
l’Ontario. Le 19 février 2007, ce document a été distribué pour
fins de consultation aux conseils de santé locaux et à environ 80 groupes
d’intérêt. Après avoir consulté le document, chaque conseil de santé doit
fournir une seule réponse consolidée par le biais d’un sondage électronique
d’ici le 9 mars 2007.
Une
stratégie de réponse suite à la consultation du document est proposée.
BACKGROUND
The MHPSG) are provincial standards that set out
the minimum requirements for fundamental public health programs and services
targeted at disease prevention, health promotion and health protection.
Legal authority
for the MHPSG is established under Section 7 of the Health Protection and Promotion Act which grants authority to the
Minister of Health and Long-Term Care to “publish guidelines for the provision
of mandatory health programs and services, and every board of health shall
comply with the published guidelines” (R.S.O. 1990m c, G, 7, s. 7(1)).
These standards
reflect the obligations of boards of health in providing and/or ensuring
locally relevant programs and services that contribute to the physical, mental
and emotional health and well-being of Ontarians. The current MHPSG were issued
in 1997, and have underpinned the services provided by Ottawa Public Health
since that time.
Following recent
cataclysmic events in North America (9/11, Anthrax, contaminated water in
Walkerton, SARS) several recent reports and governmental initiatives have
established a Public Health renewal agenda throughout Canada, including
Ontario.
In 2004, The
Ministry of Health and Long-Term Care (MOHLTC), as part of “Operation Health
Protection: An Action Plan to Prevent Threats to our Health and to Promote a
Healthy Ontario,” committed to initiating a review of the Mandatory Health
Programs and Services Guidelines.
In 2006 the MOHLTC struck a Program Standards Technical
Review Committee (TRC) to work on the MHSPG renewal. Individual members of
Ottawa Public Health staff have participated in this renewal process.
Involvement has included participation in technical and scientific workshops to
solicit feedback on the current MHPSG; membership on a writing team tasked to
prepare drafts of certain renewed program standards; and participation on the
TRC responsible to oversee the development of renewed program standards.
Throughout the development of the draft program standards, all materials and
information have remained strictly confidential.
DISCUSSION
A revised draft
MHPSG document has been produced by the MOHLTC and has been re-named Ontario Public Health Standards (see
document 1). It was released for consultation on February 19, 2007 to local
boards of health/public health units,
as well as other organizations in the health, education and aboriginal sectors.
All comments on the proposed revision must be received by the MOHLTC by
March 9, 2007 (see document 2).
We have been informed that following this consultation phase input will be
considered by the TRC, and a final draft prepared for provincial government
approval. It is not clear when this will occur, but it appears that the
Ministry wishes to have this completed during the life of the current
provincial government (i.e. by the fall). At this time there is no determined
timetable for an implementation phase.
OPH strongly recommends responding to the
consultation. Professional staff of OPH have begun to assess and analyze the
proposed new standards relevant to their program areas. Staff level input can
be obtained by March 9, 2007.
CONCLUSION
Given
the very short turn around time allowed for providing in put on the
standard, Ottawa
Public Health staff will solicit feedback from their Board of Health
(Council) via
email over the next several weeks. They will then compile those comments along with
professional staff comment for
submission to the province as the consolidated
response from Ottawa pending final Council approval. A
compilation of the feedback that is sent to the Province will be brought to
Committee and Council through the earliest
possible reporting cycle for final
disposition which will then be
forward to the Province as the final response from the
City of
Ottawa.
CONSULTATION
Staff is consulting other staff
in Ontario Public Health Units to ascertain how Boards of Health are being
engaged in other jurisdictions.
FINANCIAL IMPLICATIONS
The Ministry of Health and Long-Term Care charged that the revised
standards must fit within the Ministry’s current fiscal envelope for mandatory
programs. However in the
context of Canada’s and Ontario’s Public Health renewal agenda, as well as
growing demographically driven demands and new and emerging health threats, it
seems improbable that implementation of modernized programs will be cost
neutral.
SUPPORTING DOCUMENTATION
Document 1: Ontario Public Health
Standards, February 19, 2007 (previously distributed and held on file)
Document 2: Letter
of February 12, 2007 to Medical Officers of Health from Co-Chairs of
Technical Review Committee
(previously distributed and held on file)
DISPOSITION
The Medical Officer of Health will: write to
the Provincial Chief Medical Officer of Health requesting that the consultation
period be extended, compile feedback on the draft Ontario Public Health
Standards and submit it to the Ministry of Health and Long Term Care Technical
Review Committee (TRC) as the response from the City of Ottawa pending final Council approval at its meeting of April
11, 2007, and report back to Community and Protective Services Committee and
Council with the final compiled results on the draft Public Health Standards,
for final approval.
RÉVISION
DES LIGNES DIRECTRICES TOUCHANT LES PROGRAMMES ET SERVICES DE SANTÉ
OBLIGATOIRES
ACS2007-CPS-HEA-0001 CITY WIDE / À
L'ÉCHELLE DE LA VILLE
Chair,
Deans began by stating that this is a very detailed area and the province has
given only until 9 March to reply. It
is obvious the City must ask for a time extension.
Dr.
David Salisbury, Medical Officer of Health, provided detailed background
information on the current review of the public health mandatory health
programs and service guidelines. He
explained that the provincial Health Protection and Promotion Act is the
founding legislation that drives most public health services and requires local
boards of health (City Council), to provide public health programs and services
targeted at disease prevention, health promotion and health protection. He indicated that a revised draft of the
service guidelines was released to the public and to health units on the
February 19, 2007 and staff have been involved and have participated in both
the technical and the scientific workshops leading up to the writing of these
standards. He explained the charge of
the technical review committee as follows:
· To modernize the program standards to
reflect new science, evidence and best practices in public health
· To develop performance based outcomes,
measurements and methods, as well as increase their accountability
· To revise the standards to fit within the
current public health’s fiscal envelope
· Draft public health standards to be
presented to the acting Chief Medical Officer of Health in April 2007 with the
aim of submitting them for Ministerial approval in May/June
Focuses in the 2007
draft programs introduce two new concepts:
· Immediate measurable outcomes that
will dictate the actions of programs and interventions and for which boards
will be held accountable.
· Intermediate outcomes, which are more
long term and will hopefully flow from those immediate outcomes but the board
will not be held directly accountable for these outcomes. These are the goals,
desired social effects of various public health programs.
He further explained
that the new requirements would provide broad direction; they are designed to
be more responsive to local needs and context.
Dr. Salisbury noted that reporting would shift from only measuring
processes, to measuring output and outcomes, integrating compliance and
evaluation as part of their performance management strategy. He added that given the short turn around
time to submit the City’s response, staff intends to write to the Chief Medical
Officer of Health, requesting an extension to the deadline for receipt of
comments. He clarified that three weeks
is a very short period of time for something that is of great health importance
and long-term implications. He agreed
that after staff have provided their feedback to the MOHLTC Technical Review
Committee, they will report back to the Committee at the next meeting and
provide an update on the proceedings.
In
response to questions and comments made by Councillor Cullen, Dr. Salisbury explained
that he believed in order for them to be fully compliant, there will be a
significant gap, which would mean that this would not be cost neutral to the
City of Ottawa. Information could not
be provided at the present time of how they are currently dealing with the
situation but he hoped to have some feeling for the gap between what was
previously required, what they are capable of doing and what this new standard
would require of them. An update will
be provided when they return to the Committee in April.
That
Community and Protective Services Committee recommend that Council:
2. Recommend
that the City fforward
a letter to the Ministry of Health and Long Term Care requesting that the
consultation period be extended in order to allow for input from members of the
board of health (i.e. Members of Council).
3. dDirect
Ottawa Public Health
to compile feedback on the draft Ontario Public Health Standards and submit it
to the Ministry of Health and Long Term Care Technical Review Committee (TRC)
as the response from the City of Ottawa, pending final Council approval at its
meeting of April
11, 2007.
CARRIED
Moved by A. Cullen
WHEREAS Ottawa
Public Health staff will be compiling feedback on the draft Ontario Public
Health Standards for the Ministry of Health and Long Term Care Technical Review
Committee (TRC) as the response from the City of Ottawa;
THEREFORE
be it resolved that Councillors Cullen and Feltmate be nominated to work with a
subcommittee of staff to develop the City’s response to the Ontario Public
Health Standards and report back to Community and Protective Services Committee
on April 5th.
CARRIED
