Note: This email is going to executive directors, lead physicians, NP clinical directors, and board chairs
Dear leadership triad,
Thank you to all executive directors and admin leads who joined their regional call with us at end of January. It is always helpful to hear from you, and we hope you found the call and the chance to connect with your fellow EDs to be useful.
This email is a follow-up to provide the information promised during the calls, a summary of our call with the Ministry of Health’s Primary Health Care Branch on February 3, and a few other updates and supports.
Please see the email from last Friday, February 4, titled “COVID-19 Outpatient Therapies, Vaccination Updates, and Other Updates” for an update on COVID-19 vaccination (including aged 5-11), long COVID, RATs supply, and more.
Update from the meeting with the Primary Health Care Branch, MOH (February 3)
- The Annual Operating Plan is scheduled to be due at the end of April, and teams can expect an email on this from the Primary Health Care (PHC) Branch sometime this month. To streamline the process, they will be sending it out as a Microsoft form (i.e., survey), which can be downloaded as a PDF/word document. Teams can enter information into the word document and then copy and paste it into the online survey. Information requested will be the same as previous years, with a bit more on virtual care.
- Notification on FHT contract extension is expected this week. Teams will need to sign back on this agreement, with a March 15 deadline. E-deposits will then continue.
- AFHTO raised teams’ concerns about the expenditure guideline requirement that no single profession may account for more than 50% of the total complement unless prior ministry approval is provided in writing.
- It was noted that if a nurse is needed to do something extensive like mental health, particularly in small and/or rural teams, a case on the nursing compliment going above 50% could be made to the ministry. If there is a compelling case for a higher ratio of nursing staff, FHTs can make a business case for the change through the annual operating plan or through an in-year reallocation request. Teams are encouraged to speak with their senior program consultant.
- The PHC Branch understands that there is confusion among teams around the role of nursing staff within a FHT and has made a commitment to provide clarity of the role and expectations on nursing-funded positions. Once more information is available, we will share it with you.
- Members had inquired about using HR funding for recruitment/reallocation expenses. HR funding is not to be used for this purpose, but teams are reminded that per the ARI guidelines there is a tolerance threshold of $10,000 that can be moved between budget categories (HR to overhead) without ministry approval, which can allow you to employ tactics to support recruitment efforts. Anything beyond the tolerance threshold can only be reallocated with written approval from the ministry.
- Although not confirmed and waiting on dissemination from Ontario Health, the PHC Branch has seen next year’s QIP expectations. The timelines and release are currently with Ontario Health, and PHC Branch was unable to give a timeline for its release as it is now out of their hands.
- We know that teams continue to make unsolicited funding requests and do not always know why their proposals are rejected. To help support teams with future requests, the PHC Branch has agreed to develop a criteria checklist on what teams should be focusing on when requesting additional funding. This will help teams in preparing a business case. We do not have a timeline to share, but we will follow up with the PHC Branch a couple weeks, if needed. Stay tuned!
- We also understand that the ministry has reviewed all unsolicited business cases from 2019/20, and the teams that are going to receive additional investments have been notified. We expect an announcement in the coming weeks to highlight the teams, including some that received substantial expansion dollars to support an increased number of patients rostered.
- With year-end funds and projected surpluses, the ministry will be working with teams expecting a surplus and connecting them with teams in need of funding. If you project overspending because of COVID, the ministry can help with matchmaking now to another team that is projecting a surplus. Teams are encouraged to contact their senior program consultant as soon as possible to discuss this.
Pre-budget submission and the 2022 election
- On February 11, we will be submitting our pre-budget submission with the Primary Care Collaborative. There are 22 recommendations, broken into four sections:
- Address the HHR crisis and system capacity
- Integrate health care across Ontario
- Prioritize digital and data equity
- Create a culturally safe healthcare system that addresses health inequities
- We will share this submission with members once completed, and we will expand further on the points to provide an additional resource for election advocacy.
- If teams have recent stories of success to share that would fall in any of these categories, please send them to Beth MacKinnon to highlight in our advocacy tools.
- All advocacy tools for the 2022 election will be circulated by the end of February. We encourage you to check out who your local candidates are now and begin outreach to introduce yourself and schedule meetings for March.
Moving the yardstick on funding for team-based primary care
- AFHTO is arranging a pilot with a handful of teams in 2-3 regions to look at how we can work better together to maximize resources and expand access to team-based care based on population health needs. The pilot will be used to demonstrate how and why funding would be needed to expand even further.
- Any group of teams who would like to be part of this pilot and are interested in working together are invited to contact Bryn Hamilton.
Survey #1: Please complete this survey for the Vaccination Research Study
- AFHTO has partnered with Dr. Rachelle Ashcroft on a study focused on understanding how and in what ways primary care contributes to vaccine distribution. This includes challenges experienced by primary care in the transition to vaccine distribution, as well as generating recommendations about primary care’s ongoing and future roles in vaccine distribution, including COVID-19 boosters.
- This study will be focus groups with EDs, physicians, nurses, QIDSS, and IHPs. Please share this poll with team members so they can share interest and provide availability here: https://utorontofsw.qualtrics.com/jfe/form/SV_9ocXZYkcgB5mzPM.
- Please note, each team member can fill out this poll individually.
- Please complete this survey by Friday, February 11.
Survey #2: Please complete the Mental Health Survey
- AFHTO is supporting the OMA in collectively identifying 2-3 key priorities of mutual interest to strengthen primary care’s capacity to deliver mental health and addiction care and strengthen primary care’s ability to deliver supports to address the needs of people living with moderate-severe depression, anxiety, OCD, and opioid use problems.
- To support this work, we ask that Executive Directors/Administrative Leads of teams please fill out this quick survey: https://forms.office.com/r/u6Dueg7XV4.
- Please complete this survey by Friday, February 11.
A few other things
- Executive directors and admin leads, please join us on Wednesday, February 23 from 12:00 p.m. to 1:30 p.m. for a meeting on “Ontario Health Teams: Where are we now and what’s next?” The first 30 minutes will be with representatives from the Ministry of Health and Ontario Health, who will provide a brief update and Q&A. The last hour will be a discussion among teams. More information and registration are here.
- A session is being coordinated with Ontario Health for a broader update on the work they are doing and the chance for teams to ask questions. A date will be shared later this month.
- A reminder to check out the Monitoring Organizational Performance Toolkit and Dashboard that was developed for boards and introduced last month.
- The second phase of Ontario’s work to ease public health measures is expected on February 21. More information on the province’s reopening plan can be seen here. AFHTO, in collaboration with partners, shared concerns on the reopening plan and public health measures with the ministry prior to the first phase of reopening. You can read our letter to the minister here.
- On February 7, Nadia Surani, Director of the PHC Branch, sent a memo to teams asking them to prioritize vaccination for children if capacity allowed. If you are experiencing ongoing issues with your PHU around vaccine access or need support, please contact us so we can bring concerns to the ministry. Also check out http://www.parenthomework.ca/ for some great practical, parent-facing guidance around children’s vaccination.
A reminder to keep checking out our COVID-19 section that we regularly update with news, tools, and resources, including the daily situation reports.
Please contact us any time. We hope you are all keeping well.
Sincerely,
Your AFHTO Team