50 Report to/rapport au : Ottawa Board of Health Conseil de santé d Ottawa August 20, 2012 20 août 2012 Submitted by/soumis par : Dr./D r Isra Levy, Medical Officer of Health/Médecin chef en santé publique Contact Person / Personne ressource: Esther Moghadam, Manager/Gestionnaire Integration Quality and Standards / Intégration, Qualité et Normes Ottawa Public Health / Santé publique Ottawa 613-580-2424, ext./poste 23789 esther.moghadam@ottawa.ca CITY WIDE / À L ÉCHELLE DE LA VILLE Ref N : ACS2012-OPH-IQS-0009 SUBJECT: OBJET : OTTAWA BOARD OF HEALTH ACCOUNTABILITY AGREEMENT- 2012-2013 PERFORMANCE INDICATOR TARGETS AND AMENDING AGREEMENT NO. 4 ENTENTE DE RESPONSABILITÉ DU CONSEIL DE SANTÉ D'OTTAWA OBJECTIFS DE RENDEMENT 2012-2013 ET ENTENTE DE MODIFICATION N O 4 REPORT RECOMMANDATIONS That the Board of Health for the City of Ottawa Health Unit: 1. Confirm the performance targets for Ottawa Board of Health s Public Health Accountability Agreement 2012-2013, as outlined in Document 1; 2. Direct staff to send a letter to the Ministry of Health and Long-Term Care confirming the performance targets for Ottawa Board of Health s Public Health Accountability Agreement 2012-2013; 3. Direct the Medical Officer of Health to sign, on behalf of the Board of Health, the amended Public Health Accountability Agreement (Amending Agreement No. 4), attached as Document 2; and 4. Direct staff to forward the signed Public Health Accountability Agreement (Amending Agreement No. 4) to the Ministry of Health and Long-Term Care. RECOMMANDATIONS DU RAPPORT Que le Conseil de santé de la circonscription sanitaire de la Ville d'ottawa : 1. confirme les objectifs de rendement de l'entente de responsabilité en santé publique 2012-2013 du Conseil de santé d'ottawa tels qu'ils sont décrits dans le Document 1;
51 2. demande au personnel d'envoyer une lettre au ministère de la Santé et des Soins de longue durée pour confirmer les objectifs de rendement de l'entente de responsabilité en santé publique 2012-2013 du Conseil de santé d'ottawa; 3. demande au médecin chef en santé publique de signer, au nom du Conseil de santé, l'entente de responsabilité en santé publique modifiée (Entente de modification n o 4) ci-jointe en tant que Document 2; 4. demande au personnel de transmettre l'entente de responsabilité en santé publique signée (Entente de modification n o 4) au ministère de la Santé et des Soins de longue durée. BACKGROUND In 2011, the Ministry of Health and Long-Term Care (MOHLTC) and the Ministry of Health Promotion and Sport developed the Public Health Accountability Agreements (PHAA) as part of the continued improvement of the public health performance management framework. The PHAA is a multi-year provincial transfer payment agreement between the Ottawa Board of Health and the MOHLTC which outlines the Board s fiscal responsibility, performance obligations, reporting requirements and approved financial funding for the period of January 1, 2011 - December 31, 2013. The current PHAA proposed 14 new programs specific indicators which represent the first stage in setting performance targets for public health programs. The Board provided input on the proposed draft indicators in mid-2011 and approved that the Medical Officer of Health sign the PHAA for 2011-2013, on behalf of the Board, at its September 19, 2011 meeting (ACS2011-OPH-IQS-0009). DISCUSSION In December 2011, the MOHLTC provided all Boards of Health with specific performance indicators, baseline values and targets for 2012 and 2013. The MOHLTC instructed health units to review and accept the targets or propose alternatives. OPH proposed revisions Similar to other health units, following a detailed review of all indicators to ensure accuracy and that targets were aggressive and achievable, OPH proposed seven revisions for the 2012/2013 targets. In May 2012, the MOHLTC indicated that it had accepted four of OPH s suggested revisions (Document 1). In addition, the MOHLTC will also provide OPH an opportunity to reassess 2013 targets based on 2012 results for indicators 1, 2 and 4. Approval of Ottawa Board of Health PHAA performance targets OPH is committed, whenever possible, to achieving the targets outlined in the MOHLTC May 9, 2012 letter, and is focusing operational efforts accordingly. Consequently, OPH proposes that these targets be accepted.
52 Similar to other health units, as well as the Association of Local Public Health Agencies (alpha), OPH has identified a number of operational challenges that may, however, affect the ability to consistently achieve MOHLTC targets. Specifically: Indicators 1 and 2 (% of high risk food premises inspected once every 4 months; and % of pools and public spas by class inspected) may be affected by changes in the status of premises during the reporting period, Indicator 4 (Time between health unit notification of a case of gonorrhoea) may be affected by the need to prioritize other more urgent sexually transmitted infection cases based on clinical need or professional judgement, and Indicator 13 (% of population that exceeds the Low-Risk Drinking Guideline): OPH s proposed target was based on obtaining one-time funding grants. Achieving the Ministry s 2013 target may not be achievable given that the grant application submitted to the MOHLTC in 2012 was not successful. These operational challenges have been communicated to MOHLTC, which align with other correspondences, notably from the Association of Local Public Health Agencies (alpha) that have expressed concerns to the MOHLTC regarding both the appropriateness of some indicators and achievability of some targets. Amended Public Health Accountability Agreement (Amending Agreement No. 4) On July 17, 2012 letters from the MOHLTC were sent to the Chair of the Board of Health and the Medical Officer of Health indicating the funding provisions for 2012 funding year. This correspondence also included an amended Public Health Accountability Agreement (Amending Agreement No. 4) which outlines the terms and conditions governing this funding, and details of 2012 Program-Based Grants (Document 2). The amended Accountability Agreement includes revised information on the 2012 Program-Based Grants (Schedule A-4); updated Related Program Policies and Guidelines (Schedule B-4); Reporting Requirements (Schedule C-3); and Board of Health Performance (Schedule D-1). In reviewing the Amending Agreement No. 4, and taking into consideration the operational challenges previously mentioned, OPH aims to fulfill the reporting requirements as outlined in the Amended Agreement. PHAA Reporting Process Reporting on Accountability Agreement Indicators will begin for the period ending June 30, 2012. OPH will monitor progress on PHAA performance indicator targets and may need to reallocate resources to meet targets. OPH will report to the Board in line with the Ministry s reporting timelines. Future Directions Work is currently underway to develop indicators for the Ontario Public Health Organizational Standards, with measurement to begin in 2012. Other developmental
53 indicators to be further defined during 2012 relate to: physical activity, healthy eating and nutrition, child and reproductive health, comprehensive tobacco control and equity. MOHLTC has reiterated commitment to consulting with health units during the development phase. CONSULTATION The MOHLTC surveyed health units including board members in May 2011 regarding the proposed Accountability Agreement. LEGAL IMPLICATIONS There are no legal impediments to the implementation of the report recommendations. FINANCIAL IMPLICATIONS There are no financial implications in implementing the recommendations of this report. TECHNOLOGY IMPLICATIONS There are no technology implications in implementing the recommendations of this report. BOARD OF HEALTH STRATEGIC PLAN The recommendations in this report support the Board of Health Strategic Priority: Measure and report publicly on progress (E3). TERM OF COUNCIL PRIORITIES The recommendations in this report support the 2010-2014 Term of Council Priorities with regard to governance, planning and decision-making. SUPPORTING DOCUMENTATION DOCUMENT 1 - Letter from Roselle Martino and Kate Manson-Smith, from the MOHLTC to Medical Officer of Health, Dr. Isra Levy, Ottawa Public Health, regarding performance targets for the 2011-2013 Public Health Accountability Agreement, May 9, 2012 (Kept on file with the Board of Health Secretary) DOCUMENT 2 - Amended Public Health Accountability Agreement (Amending Agreement No. 4), for the Ottawa Board of Health (kept on file with the Board of Health Secretary) DISPOSITION Ottawa Public Health staff will aim to ensure the Board of Health is able to fulfill its obligations as outlined in the Amended Public Health Accountability Agreement (Amending Agreement No. 4). The Medical Officer of Health will confirm acceptance of the PHAA performance indicator targets by the Ottawa Board of Health through a letter
54 to the MOHLTC. The Medical Officer of Health will sign the Agreement on behalf of the Board of Health and OPH staff will send the signed Agreement to the MOHLTC.