Updates from meeting with MOHLTC Primary Health Care Branch

AFHTO’s Operational Issues Working Group met yesterday (March 6) with Mary Fleming, Director of Primary Health Care Branch; Richard Yampolsky, Program Manager, FHT Implementation; Gayle Barr, Senior Program Consultant; and Erin Weinkauf, Program Analyst. Flexibility in Operating Plans and Budgets The need for greater flexibility, consistency and transparency in budgets was the central theme throughout the meeting.  The Ministry confirmed:

• It is moving toward more broadly defined `buckets` of funds to give greater flexibility.  The FHT Unit hopes to confirm what these are by July, possibly sooner.
• FHTs do have some flexibility in determining the mix of IHPs in the team in circumstances such as unfilled positions. The request to change will need approval as would be expected. The line item for this will be associated with the benchmark of the requested IHP.
• The Ministry benchmark for funding IT connectivity has been judged to be adequate by OntarioMD and eHealth Ontario. DSL is the standard.  Unique circumstances could be discussed, but the benchmark will not be altered. Concrete examples of issues directly related to connectivity are useful to make the case for operational needs.
• It is looking into the issue of relief funding to backfill reception and nursing positions to cover operating commitments, within government funding constraints and where physicians are not the ones obliged to cover these costs.

The Ministry is open to considering a more sustainable approach to funding IT hardware replacement. AFHTO has committed to looking at methods used in other sectors and developing a proposal.  Additional volunteer assistance is welcome. Ministry Policy Priorities: Integrating Primary Care into LHINs:  MOHLTC continues to confirm there will be consultation as this process unfolds. MOHLTC has not yet named a lead branch for this initiative. After hours care: The Ministry is not releasing results to date from the first 3 years of the 5-year FHT evaluation study, however we are told they indicate significant improvement needed in delivering after hours care. The comments may have been prompted by the just-released ICES study – Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Dept Use.  It found that FHTs, FHNs and FHOs had patient populations with higher-than-expected ED visits, whereas FHGs and CHCs had lower-than-expected ED visits.  AFHTO will be examining this question more closely. House calls:  Increasing house calls was part of government`s campaign promise, and FHTs are expected to do their part. A number of Toronto FHTs are part of the `Bridges` pilot to test implementation models.  The issues of travel support and reduced number of client visits have been identified to date.  AFHTO will be monitoring. Additional updates: NPAR:  Evaluation is expected to be completed in late May. No further expansion will take place till after that date. Streamlining quarterly data collection: FHT Unit is committed to doing this and will consult with the relevant associations in the near future. Post comments on ED Collaborative Space: FYI – Briefing notes presented at this meeting are posted on AFHTO’s ED Collaborative Space.  (FHT EDs received a username and password on February 24. Contact info@afhto.ca if you need help.) Use this space to ask questions and compare notes with your peers. AFHTO collaboration on operational issues with the AOHC CFHT group: AFHTO is committed to strengthening the voice for all FHTs – 93% of which belong to our association today.  A number of community-governed FHTs belong to both AFHTO and the Association of Ontario Health Centres. With AOHC support their CFHT group has tackled a number of operational issues with the FHT Unit.  AFHTO`s Operational Issues Working Group and the AOHC CFHT group have come together to meet jointly with the Ministry to deliver well-developed, consistent messages.  The briefing notes posted on AFHTO’s ED Collaborative Space (see above) are the result of our combined work. Through AFHTO’s CFHT rep, Michelle Karker (contact info below), CFHTs will receive an update on discussions regarding the Blended Salary Model in the near future. Thank you to AFHTO`s Operational Issues Working Group The Operational Issues Working Group members volunteer their time and leadership on behalf of all FHTs.  Each one is the “point person” for a group of AFHTO members and is interested in hearing from you through the ED Collaborative space or via e-mail.

• For FHT EDs in LHINs 1-4 and 12 (Erie St. Clair, South West, Waterloo Wellington, Hamilton Niagara Haldimand Brant, North Simcoe Muskoka) and all CFHTs across the province:
  • Michelle Karker, ED East Wellington Community FHT
  • E-mail:  michelle.karker@ewfht.ca
• For FHT EDs in LHINs 5-8 (Mississauga Halton, Central West, Toronto Central, Central)
  • Kavita Mehta, ED South East Toronto FHT, Working Group Chair, AFHTO President
  • E-mail:  kavita.mehta@setfht.on.ca
• For FHT EDs in LHINs 9-11 (Central East, South East, Champlain):
  • Joyce Phillips, ED Kingston FHT
  • E-mail:  jphillips@kfhn.net
• For FHT EDs in LHINs 13-14 (North East, North West)
  • Randy Belair, ED Sunset Country FHT,  AFHTO Secretary
  • E-mail:  rbelair@kfht.ca
• For FHT Clinical Leads:
  • John McDonald, Lead Physician PrimaCare Community FHT, AFHTO Past President
  • E-mail:  john.mcd1@sympatico.ca