Item - 2016.HL9.3
Tracking Status
- City Council adopted this item on February 3, 2016 without amendments and without debate.
- This item was considered by Board of Health on January 25, 2016 and was adopted with amendments. It will be considered by City Council on February 3, 2016.
HL9.3 - Healthy People First: Opportunities and Risks in Health System Transformation in Ontario
- Decision Type:
- ACTION
- Status:
- Adopted on Consent
- Wards:
- All
City Council Decision
City Council on February 3 and 4, 2016, adopted the following:
1. City Council request the Minister of Health and Long-Term Care to ensure a continued strong role for public health in keeping people healthy by:
a. maintaining independent governance of the local public health sector by boards of health;
b. strengthening comprehensive provincial standards for public health through the current review of the Ontario Public Health Standards, especially for healthy public policy and other programs that keep people healthy; and
c. ensuring that Public Health Units continue to be directly funded by the Province.
2. City Council request the Minister of Health and Long-Term Care to mandate a formal relationship between Local Health Integration Networks and senior representatives of the healthcare, municipal, education, social service and voluntary sectors as well as the Medical Officer of Health to support population health planning and service coordination in order to improve health equity and address social determinants of health.
3. City Council request the Minister of Health and Long Term Care to provide the necessary resources to Local Health Integration Networks and Boards of Health to support collaboration on population health planning of health services.
4. City Council request the Minister of Health and Long Term Care to adjust Local Health Integration Network boundaries to create geographic alignment with the boundaries of municipalities, school boards, and public health units, including creating one Local Health Integration Network for the City of Toronto.
5. City Council request the Minister of Health and Long Term Care to create transparent accountability indicators and targets for Local Health Integration Networks which include population health and health equity.
Background Information (Board)
https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-88525.pdf
(December 17, 2015) Attachment 1: Ministry of Health and Long-Term Care. (2015). Patients first: A proposal to strengthen patient-centred health care in Ontario. Discussion Paper December, 2015.
https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-88526.pdf
Attachment 2: The Impacts on the Public Health Function with Integration with Regionalized Healthcare Systems. Moloughney, B. (2016)
https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-88527.pdf
(January 11, 2016) Report from the Medical Officer of Health on The Future of Public Health in Ontario - Opportunities and Risks - Notice of Pending Report
https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-87293.pdf
Background Information (City Council)
https://www.toronto.ca/legdocs/mmis/2016/cc/bgrd/backgroundfile-90085.pdf
HL9.3 - Healthy People First: Opportunities and Risks in Health System Transformation in Ontario
- Decision Type:
- ACTION
- Status:
- Amended
- Wards:
- All
Board Recommendations
The Board of Health recommends that:
1. City Council request the Minister of Health and Long-Term Care to ensure a continued strong role for public health in keeping people healthy by:
a. Maintaining independent governance of the local public health sector by boards of health;
b. Strengthening comprehensive provincial standards for public health through the current review of the Ontario Public Health Standards, especially for healthy public policy and other programs that keep people healthy;
c. Ensuring that Public Health Units continue to be directly funded by the province.
2. City Council request the Minister of Health and Long-Term Care to mandate a formal relationship between Local Health Integration Networks (LHINs) and senior representatives of the healthcare, municipal, education, social service and voluntary sectors as well as the Medical Officer of Health to support population health planning and service coordination in order to improve health equity and address social determinants of health;
3. City Council request the Minister of Health and Long Term Care to provide the necessary resources to Local Health Integration Networks (LHINs) and Boards of Health to support collaboration on population health planning of health services;
4. City Council request the Minister of Health and Long Term Care to adjust Local Health Integration Network (LHIN) boundaries to create geographic alignment with the boundaries of municipalities, school boards, and public health units, including creating one LHIN for the City of Toronto; and
5. City Council request the Minister of Health and Long Term Care to create transparent accountability indicators and targets for Local Health Integration Networks (LHINs) which include population health and health equity.
Decision Advice and Other Information
The Board of Health:
1. Requested the Minister of Health and Long-Term Care to ensure a continued strong role for public health in keeping people healthy by:
a. Maintaining independent governance of the local public health sector by boards of health;
b. Strengthening comprehensive provincial standards for public health through the current review of the Ontario Public Health Standards, especially for healthy public policy and other programs that keep people healthy;
c. Ensuring that Public Health Units continue to be directly funded by the province.
2. Requested the Minister of Health and Long-Term Care to mandate a formal relationship between Local Health Integration Networks (LHINs) and senior representatives of the healthcare, municipal, education, social service and voluntary sectors as well as the Medical Officer of Health to support population health planning and service coordination in order to improve health equity and address social determinants of health;
3. Requested the Minister of Health and Long Term Care to provide the necessary resources to Local Health Integration Networks (LHINs) and Boards of Health to support collaboration on population health planning of health services;
4. Requested the Minister of Health and Long Term Care to adjust Local Health Integration Network (LHIN) boundaries to create geographic alignment with the boundaries of municipalities, school boards, and public health units, including creating one LHIN for the City of Toronto;
5. Requested the Minister of Health and Long Term Care to create transparent accountability indicators and targets for Local Health Integration Networks (LHINs) which include population health and health equity;
6. Forwarded Recommendations 1 to 5 of the Report (January 11, 2016) from the Medical Officer of Health, to City Council for adoption; and
7. Forwarded the report (January 11, 2016) from the Medical Officer of Health to the Association of Local Public Health Agencies, the Council of Ontario Medical Officers of Health, the Ontario Public Health Association, the Association of Municipalities of Ontario, the Toronto City Manager, all 14 Local Health Integration Networks (LHINs), the 36 Ontario boards of health, the Toronto School Boards, and Dalla Lana Faculty of Public Health, University of Toronto.
Origin
Summary
The Ontario Ministry of Health and Long-Term Care (MOHLTC) released Patients First: A proposal to strengthen patient-centred health care in Ontario in December 2015 with the goal of addressing structural issues in the health care system that create inequities (Attachment 1). The Patients First discussion paper proposes expanding the role of the Local Health Integration Networks (LHINs) to include funding and accountability for public health.
The experience of other Canadian provinces with formal integration of public health and the larger health system suggests that opportunities for system improvement have often not been realized, and unintended risks to public health have arisen. This report reviews the implications of the MOHLTC proposals and recommends a response from the Board of Health (BOH) with particular attention to proposals with implications for local public health.
Public health plays a key role in population health and the sustainability of the health system by keeping people healthy. To minimize the risk of proposed changes compromising these contributions, the Medical Officer of Health (MOH) recommends that the BOH endorse maintaining independent governance of public health by local boards of health, protected and transparent funding for public health, and strengthened Ontario Public Health Standards.
Patients First also calls for local public health to play a formal role in planning of health care services to improve population health and health equity. Because health inequities are grounded in social determinants of health outside the health care system, the system must partner with non-health sectors beyond public health to realize this goal. The MOH recommends that the MOHLTC mandate formal local relationships between LHINs and the municipal, education, social service and voluntary sectors as well as public health. Realignment of LHIN boundaries with the other sectors is necessary to enable intersectoral collaboration.
Background Information
https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-88525.pdf
(December 17, 2015) Attachment 1: Ministry of Health and Long-Term Care. (2015). Patients first: A proposal to strengthen patient-centred health care in Ontario. Discussion Paper December, 2015.
https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-88526.pdf
Attachment 2: The Impacts on the Public Health Function with Integration with Regionalized Healthcare Systems. Moloughney, B. (2016)
https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-88527.pdf
(January 11, 2016) Report from the Medical Officer of Health on The Future of Public Health in Ontario - Opportunities and Risks - Notice of Pending Report
https://www.toronto.ca/legdocs/mmis/2016/hl/bgrd/backgroundfile-87293.pdf
Speakers
Dr. Kwame McKenzie, Chief Executive Officer, Wellesley Institute
Motions
That Recommendation 1 c. be deleted and replaced with the following:
"c. Ensuring that Public Health Units continue to be directly funded by the province."