Ultimate Blogging Championship

Tag: Policy Issues

  • Ministry Communications Toolkit, OCFP Resources and Science Table Brief on Primary Care Webinar

    Dear Members,

    As we move into another fall season where we are seeing hospital emergency department surges due to an increase in respiratory viral illnesses in Ontario, it’s even more critical to ensure everyone gets their flu shot and stays up to date on their COVID19 booster shots. Flu shots for the general public should be available as of November 1st through primary care offices and pharmacies – if you are having issues with accessing your vaccines, please connect with your PHU to facilitate distribution. As we prepare for what may be a difficult fall, we wanted to share with you some resources and tools you may find helpful.

    From the Ministry of Health
    The Ministry has developed a toolkit of communication resources with key messages and materials to help ensure Ontarians have a clear understanding of the COVID-19 booster dose recommendations and the importance of why and when they should receive a booster dose. Booster doses are recommended to everyone aged five and over to help restore protection that may have decreased since their last dose:

     

    • Individuals aged five and over who are not considered high risk for severe COVID-19 illness are recommended to receive a booster dose six months since their last dose.
    • It’s strongly recommended that the following individuals get a booster dose after three months:

    The toolkit includes:

    The Ministry has shared the most recent slide deck from October 14, 2022, which contains the provincial dashboard on COVID vaccination by age groups and priority populations. Note that Page 4 contains a Flow Diagram for COVID-19 Booster Vaccination – When Should you get a Booster Dose that may be helpful when counseling patients.  

    The Ministry also shared the Indigenous Vaccination Dashboard which lays out the rollout of the COVID-19 vaccine to Indigenous adults, including Operation Remote Immunity. This includes First Nations, Métis, Inuit, and urban populations 5+. The IPHCC has done tremendous work in addressing vaccine hesitancy and increasing vaccination in the Indigenous communities using culturally safe learnings and approaches. Members are encouraged to read through the work done to date and to utilize the rich resources that are available for use.

    Other updated Ministry of Health resources you may find helpful:

    •  COVID-19 vaccine guidance (MOH, October 13) (EN, FR)
      • Monovalent Pfizer-BioNTech Primary Series for 6 months –4 years
      • Updated recommendations for those who are pregnant and/or breastfeeding (alignment with NACI)
      • Bivalent Pfizer-BioNTech booster for 12 years and older (available this week in Ontario)
      • “There is no preference between bivalent Pfizer-BioNTech and bivalent Moderna for booster doses in individuals 18 years of age and older”
    • Storage and handling of Pfizer-BioNTech’s COVID-19 vaccines (MOH, updated October 13) (EN)
    • COVID-19 vaccine consent and notice form (MOH, updated October 6) (EN, FR)
    • COVID-19 guidance: Long-term care homes, retirement homes, and other congregate living settings for public health units (MOH, updated October 6) (EN, FR)
    • COVID-19 provincial testing guidance (MOH, updated October 6) (EN, FR)

    Other Helpful Tools and Resources from the OCFP

    The Ontario College of Family Physicians (OCFP) has developed several tools that you may find helpful when managing patients with respiratory symptoms in your clinics:

    From Ontario Health
    As noted in our October 6th communique to EDs and admin leads, Ontario Health had sent out a memo on October 3 on Evusheld, a therapy against COVID-19. The memo was for healthcare providers and outlines what Evusheld is, who can receive Evusheld, and how to access it for eligible patients. It also includes a link to a revised toolkit for providers who may be prescribing or administering Evusheld.

    If you have not seen it, the memo with all the resource links can be found here – EN FR.  The memo also references the following resources:

    • Information about Evusheld (tixagevimab and cilgavimab): Reference for health care providers who may be prescribing or administering Evusheld EN
    • Patient handout on Evusheld EN FR

    Events and Webinars

    Breakfast Webinar: Highlights and Implications of the Ontario Science Table’s Brief on Primary Care
    On October 3, 2022, the Ontario COVID-19 Science Advisory Table (OST) released its final brief, a 3-part exploration of how primary care responded to and was affected by the pandemic, and implications for ongoing health system planning and policy:

    Join on November 30th at 7:45 a.m. to 8:45 a.m. to hear from key primary care leaders as they share some of the more significant findings and implications. Panelists include:

    • Dr. Imaan Bayoumi: Assistant Professor of Family Medicine and Public Health Sciences at Queens University, Family Physician, Member of the Ontario Science Table
    • Dr. Danielle Martin: Chair of the Department of Family and Community Medicine at the University of Toronto, Family Physician at Women’s College Hospital, Member of the Ontario Science Table
    • Dr. Noah Ivers: Family Physician at Women’s College Hospital, Scientist at the Women’s College Research Institute, Associate Professor in the Department of Family and Community Medicine at the University of Toronto, Member of the Ontario Science Table
    • Dr. Jennifer Rayner: Director of Research and Evaluation at the Alliance for Healthier Communities, Adjunct Research Professor at Western University, Contributor to the Ontario Science Table Briefs on Primary Care

    IPAC for Non-clinical Staff (PH Ontario)
    This course is designed specifically for people who don’t have formal health care training and work in a congregate living environment. It will provide learners with the IPAC knowledge they need to keep themselves, their patients, and their co-workers safe from infections in workplaces like shelters, group homes, residential treatment centres and other facilities. Participants will learn how to conduct a risk assessment, perform proper hand hygiene, when and how to use personal protective equipment safely, the basics of administrative and environmental infection control measures, and best practices for outbreak management. Click here to learn more.

    Thank you again for all you are doing to keep your patients and the community safe. If you need any assistance or have any questions, please do not hesitate to contact us. Stay safe and Happy Halloween.

    Yours in good health,

    The AFHTO Team

  • Bits & Pieces: mental health week, updated Directive #2 Q&A, phase 2 prioritization and more

    Bits & Pieces: mental health week, updated Directive #2 Q&A, phase 2 prioritization and more

    Your Weekly News & Updates

    In This Issue  
    • Mental Health Week
    • Member stories
    • Updated Directive #2 Q&A, phase 2 prioritization, supporting patients with IDD and more
    • Reminder- EMR/EHR Auditing Obligations, May 7, 2021
    • Free seated desk yoga, May 12
    • Mask removal rules for the lunchroom
    • Seeking input on an occupational medicine mentoring program curriculum
    • Patients and caregivers needed for primary health care team policy discussion
    • Upcoming events including NACI recommendations on extended dose intervals and effectiveness of COVID-19 vaccines and more

    CMHA Name it, don't numb it. Child crying with the word 'sad'.

    Mental Health Week

    Mental Health Week is being observed May 3-9, 2021. The theme of this year is understanding our emotions, key during COVID-19 when 40% of Canadians say their mental health has deteriorated since the onset of the pandemic. You can take part and access toolkits at https://mentalhealthweek.ca/.

     

    Staff at Arnprior drive through vaccine clinic processing a patient

     

    Member stories

    Arnprior & District FHT– Arnprior & District FHT, VTAC and COVID-19 vaccination drive through clinics

    Madawaska Valley FHT – Madawaska Valley FHT NPs start their own practice

    You can share your own stories with our member initiative webform. If you have any questions, please email us at info@afhto.ca.

     

     

     

     

     

    Updated Directive #2 Q&A, phase 2 prioritization, supporting patients with IDD and more

    Recent updates include:

    We continue to update several pages on our site with resources and news:

    Reminder- EMR/EHR Auditing Obligations, May 7, 2021

    Join Kate Dewhirst Law 12 p.m. to 1:30 p.m. to better understand the obligations to audit EMR and EHRs.  To be discussed:

    • Why do you have to audit?
    • What’s new in the 2020 changes to PHIPA about audits of electronic systems
    • Contractual obligations when signed onto Connecting Ontario platforms or sharing systems with OHT partners or other agencies in your geographic region
    • How often should you audit?
    • What do you have to audit?
    • How do you audit?
    • What tools to use to document your auditing practices

    Register here.

    GoodLife yoga flyer may

     

    Free seated desk yoga, May 12

    On May 12 at 12 noon, GoodLife is offering a free 45-minute virtual seated desk yoga class for healthcare workers. Click on the link in the poster to join. Space is limited so arrive early.

     

     

     

     

     

     

     

    Mask removal rules for the lunchroom
    Per Maria McDonald, McDonald HR law:

    On April 23, 2021, the Government of Ontario introduced new rules about removing masks to eat or drink at work (Regulation 82/20 see section 2 (5.1)).

    Specifically, a person responsible for an organization which is opened shall ensure workers who remove their mask or face covering to eat or drink, are separated from all other people by:
    (a)  a distance of at least two metres; or
    (b)  plexiglass or some other impermeable barrier.

    Please take this into consideration as it relates to your clinics.

    Seeking input on an occupational medicine mentoring program curriculum

    How confident do you feel about identifying a work-related illness, completing a WSIB Form 8, or doing a functional abilities assessment with injured patients?  You can get support on these topics and more through the new Project ECHO Occupational and Environmental Medicine (OEM) for Ontario healthcare providers. Help tailor the program curriculum by completing a short needs assessment before May 10th. It takes less than 10 minutes, and you could win a $50 gift card. The (free) ECHO OEM program launches this fall.  Take the short survey.

    Patients and caregivers needed for primary health care team policy discussion

    Researchers including Drs. Sharon Johnston (Bruyere/University of Ottawa) and Catherine Donnelly (Queen’s University) are inviting interested patients, family members and caregivers to participate in an online discussion about patient and caregiver involvement in building policies on primary health care teams and applying them.

    This is part of a larger study led by Dr. Nelly Oelke (Nursing, UBC, Okanagan) in four provinces, including British Columbia, Alberta, Ontario, and Quebec, to explore Canada’s approaches to improving health system integration. Participants will receive an honorarium for their participation and should RSVP by Wednesday, May 12th, 2021.  Learn more here.

    Recommendations of the National Advisory Committee on Immunization (NACI) on Extended Dose Intervals and Effectiveness of COVID-19 Vaccines, May 5, 2021
    Public Health Agency of Canada (PHAC) Webinar for Health Care Providers. Register here.

    Project ECHO: Ontario Bariatric Network, Starting May 6 & June 2, 2021
    Join these OBN Project ECHO Series held by Guelph General Hospital BCOE & The Ottawa Hospital BCOE.
    Find out more here.

    OCFP COVID CoP: Variants, the J&J vaccine, VIIT, and more, May 7, 2021
    Learn more about variants of concern, the Johnson & Johnson vaccine & helping patients weigh the risk and benefits of viral vector vaccines in light of Vaccine Induced Immune Thrombotic Thrombocytopenia.
    Register here.

    Choosing Wisely Canada’s Virtual National Meeting, May 12 – 13, 2021
    Remember to register for Choosing Wisely’s 2-day national meeting, in collaboration with the CMA.
    Learn more here.

    Child & Youth Eating Disorders: Information for Primary Care, May 18 – Jun. 15, 2021
    This special interest ECHO session series will cover:

    • Understanding Eating Disorders and Assessment of Children and Youth with Eating Disorders, May 18, 2021
    • Understanding Medical Implications and Monitoring for Children and Youth with Eating Disorders, June 1, 2021
    • Supporting a Young Person with an Eating Disorder in Primary Care – Tips and Tricks for the Primary Care Provider, June 15, 2021

    For more information, click here.

    CFPC Pivots: May & June 2021

    • The Art And Science Of Medication Optimization For Heart Failure With Reduced Ejection Fraction, May 18, 2021
    • At A Loss For Weight Loss? Scaling Down The Evidence For Primary Care, June 8, 2021

    To access the webinar links, click here.

  • AFHTO response to public health modernization

    As government undergoes public health modernization, AFHTO is pleased to provide a few recommendations to better align primary care with public health. Together with government, we will build more coordinated, integrated and person-centered health care for the people of Ontario.

    1. Strengthen the relationship between primary care and public health to better align with health system transformation- we recommend that public health be better integrated within the health system planning as a full partner that, alongside primary care, ensures prevention, health promotion, wellbeing, and chronic disease management be part of the full continuum of care for patients and the population being served.
    2. Improved communications and integrated digital health systems – Though the ideal state is to create one electronic medical record for patients, in absence of adopting one EMR for the province, we suggest thought be given on how better to integrate, connect, and coordinate health promotion, health protection, and health care between primary care and public health.
    3. Establish local pubic health service delivery areas that are aligned with Ontario Health Teams – We suggest delivery areas be aligned with Ontario Health Teams or with existing municipal boundaries to avoid confusion for providers who are seeking local resources or supports.

    Read the full document here.

  • Second Interim Report from the Premier’s Council on Improving Healthcare and Ending Hallway Medicine

    The Premier’s Council on Improving Healthcare and Ending Hallway Medicine released its second interim report on June 25, 2019, entitled “A Healthy Ontario: Building a Sustainable Health Care System.”

     

    This report contains ten policy recommendations from the council to the government, intended to help the government stay on track as it works to improve the health care system. 

     

    The third recommendation is that primary care be the foundation of an integrated health care system. As examples, the report suggests ensuring OHTs facilitate clinician leadership and support strong partnerships with the primary care sector. 

     

    The report also includes support and recommendations for wrap-around care, comprehensive care plans, and “providers working in a team environment with access to a full continuum of care for their patients, as well as continued professional development support and resources.”

     

    AFHTO is pleased to see the importance of primary care outlined in the second interim report.

     

    The council consulted over 1,500 providers, patients and stakeholders – including AFHTO members – and says it will continue to engage the public on how to improve the health care system as it develops future reports with updates on how these initiatives are improving health care service delivery.

     

     

    Reports and resources:

     

     

     

     

     

     

  • Provincial Policy Manual for Primary Care Teams and Practices

    We are pleased to share the Provincial Policy Manual developed for primary care.

    The policy templates can be used by primary care teams across the province or by other primary care practices (solo physicians and non-team based clinics). The manual gives you the flexibility to determine, for your own practice or setting, what policies are required, and whether/how they should be tailored for your unique circumstances. To be effective, policies should be reviewed on a regular basis (e.g. every 2 to 3 years) to ensure that they continue to be compliant with legislation, and to assess whether they are achieving their stated goal.

    AFHTO will be updating policies in this manual annually. Although all the policy templates in the manual have been reviewed by legal and HR expertise, users should consult with their own legal counsel for advice pertaining to the use of these policies.

    We would like to thank the Partnering for Quality Program for its contribution to the development of this policy manual, with special thanks to Clinton FHT, West Durham FHT and Thames Valley FHT. The Partnering for Quality Program is a regional program in the South West LHIN that aims to improve information management and collaboration between primary care and community health care partners with the ultimate goal of improving chronic disease prevention.

     

    Looking for more Governance and Leadership Tools & Resources? Click here to explore more.

  • Report on behalf of the Primary Health Care Expert Advisory Committee

    Dear AFHTO members: As you see below, Minister Hoskins has released the Report on behalf of the Primary Health Care Expert Advisory Committee and invited feedback. With the AFHTO Conference less than two weeks away, we have a ripe opportunity to engage members in developing AFHTO’s response.  AFHTO staff and the AFHTO board executive are working through the opportunities in the conference program, and will be back to you with updates early next week. As it says in the title of AFHTO’s 2015 Annual Report, released yesterday in the Annual General Meeting notice – we have Collective Impact: The Power to Shape Our Future. We look forward to the discussions at the AGM and conference. Angie Angie Heydon, Chief Executive Officer Direct phone: (647) 234-8503 | Email: angie.heydon@afhto.ca

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    On behalf of the Ministry of Health and Long Term Care, I’m pleased to provide you with a copy of the Baker-Price Report on Primary Care. Our government is committed to improving performance, accountability, and access in Ontario’s primary-care sector. Our priority is to put patients first by ensuring that primary-care providers and services are organized around the needs of the population. This includes ensuring access to a primary-care provider for every Ontarian that wants one. That is why we engaged a panel of experts to provide advice on how to improve the delivery of primary care for Ontarians. The panel, led by Elizabeth Baker and Dr. David Price, was asked to provide advice on ways to better integrate primary-care providers with each other and within the health-care system. They also looked at how we can continue improving access to primary care and to interdisciplinary care teams. We thank the panel for their work and their report. The report is one of many pieces of advice the government is considering when discussing how to strengthen primary care in Ontario. This report, along with the recommendations of other reports submitted to the government over the past few years, will help inform our work as we go forward. It’s important to know that as we go forward we do not intend to create additional layers of administration. We are focussed on ensuring Ontarians are connected to a primary care provider and can see them in a timely way when they are sick. We are also committed to letting patients choose their own provider. I look forward to discussing the future of primary care with you as soon as you’ve had an opportunity to develop your thoughts – and am happy to answer any questions you may have now. Jesse Rosenberg Director of Policy Ontario’s Minister of Health and Long Term Care  

  • Forging Ahead: AFHTO members preparing for next stage of primary care evolution

    Government announcements are anticipated in early September. This email summarizes priorities for AFHTO, set through the ED Advisory Council (interview results and July 28th meeting), Physician Leadership Council (July 30th meeting) and AFHTO Board (August 12th). In light of government’s communications to date, the 5 priorities identified for AFHTO were:

    1. Developing and strengthening relationships with (and education for) LHINs, in anticipation of a tighter relationship between LHINs and primary care.
    2. Addressing the province’s intent to broaden access to teams while ensuring teams can continue to deliver quality care.
    3. Determining how to measure “Capacity” – a fundamental component in assuring quality care.
    4. Shaping what it means to take a “Population-Based Approach to Primary Care”.
    5. Strengthening governance of teams – a critical requirement for leading this next stage in primary care’s evolution.

    Scroll down to read more about these priorities.

    Stay Tuned:

    • Sept. 17 — The ED Advisory and Physician Leadership Councils will meet together to review further developments from government and plan next steps.
    • Oct. 28 — Leadership session at the AFHTO conference is open to leaders of all member organizations.
    • November through February — AFHTO is organizing “Regional Leadership Sessions” – to include AFHTO leadership, FHT/NPLC EDs, Lead Physicians, Board Chairs, LHIN leadership, and other stakeholders deemed appropriate within each LHIN region.

    What can you do now? Relationships are fundamental…start getting to know the FHTs/NPLCs in your region, think about how you could strengthen partnerships with the LHIN or how AFHTO might assist! Moving Forward – AFHTO will continue to engage our membership and keep everyone informed as soon as formal announcements are made or direction is received.  Working together we will identify and provide the necessary education, training and guidance needed to lead the way for comprehensive, high-quality, team-based primary care.

    1.    Relationship with/Education for LHINs

    All members – EDAC, PLC and the AFHTO board – as a priority to be addressed immediately, to prepare for the evolution ahead. Next Steps:

    • To build profile for FHTs and NPLCs with each LHIN CEO, ED Advisory Council reps have been invited to join with AFHTO’s ED (and one or two other EDs/Lead MDs) in meeting with their respective LHIN CEOs.
    • To foster greater understanding about primary care across LHIN staff, AFHTO has initiated development of educational material together with the LHIN Collaborative.
    • These two activities will help set the stage for Regional Leadership Sessions in each LHIN (November through February).

    2.   Broadening Access to Teams

    The Ministry has been clear on a shift toward improving “Access to team-based primary care for all Ontarians who would most benefit” – currently only a quarter of the population is served by FHTs/NPLCs and have access to IHPs within team based care. HOW this is done, lends itself to a number of challenges and potential opportunities. How primary care is organized going forward, the possible role of the LHIN, and expectations of FHTs/NPLCs will be key factors in determining how we can broaden access to team based care. Next Steps:

    • AFHTO’s paper on optimizing value of and access to team-based primary care presents evidence-informed advice on how to spread access to high-quality team-based primary care in a way that achieves the best value, and provides a number of recommendations to the Ministry.
    • The joint EDAC/PLC in-person meeting on September 17th will identify areas for further recommendations for the Ministry and members on approaches to broadening access to teams (including addressing challenges such as liability).

    3.   Advancing Capacity Measurement

    Team capacity has been the core issue for FHTs and NPLCs seeking Ministry funding to meet patient needs. As the province calls for broader access to teams, this will be THE number one issue – what can teams take on while assuring quality of care? Quality, capacity and total cost of care are the core concepts for measurement in the “Starfield Principles”, adopted by AFHTO. Through D2D 2.0, we have progressed in measuring cost and quality. AFHTO members, staff and other stakeholders are working to find meaningful ways to measure capacity. Expanding access to teams only makes sense where capacity is sufficiently developed. Next Steps:

    • In-depth clinical consultations are underway on capacity measurement (and other strategic indicators). Click here to participate.
    • Aiming to include a capacity measure in D2D 3.0 (launching January 2016).

    4.   Population-based Approach to Primary Care

    MOHLTC leaders have consistently used the term “population-based primary health services for Ontarians”. Working collaboratively to plan and offer programs and services that are designed to meet the specific needs of the patient population will be central to implementing a population based approach. Next Steps

    • AFHTO will continue to work with the Ministry and other stakeholders to establish a clear definition and principles of a population-based approach to primary care.
    • AFHTO is establishing a joint Work Group with MOHLTC PHC Branch to improve the approach to program planning and the ministry’s template for reporting on program plans (Schedule A in FHT contracts/Schedule E in NPLC contracts). A workshop will be provided at the AFHTO 2015 conference with a focus on: what constitutes a program; key elements of a well-designed population-based approach to program planning; how to conduct a needs assessment; goal setting; performance measurement principles and evaluation; and how to use the reporting tool effectively.
    • Members are encouraged to start looking at their own communities, to get to know the teams in the same geographic region, and to begin to explore ways that teams can reach out to larger segments of the population that are not formally rostered patients.

    5.    Governance of Teams

    Given the Ministry’s anticipated announcement, strong governance and leadership practices will be even more paramount for FHTs/NPLCs to successfully navigate the upcoming transition and change. Next Steps:

    • AFHTO is offering the Effective Governance for Quality in Primary Care workshop to AFHTO member board members, executive directors and lead clinicians on October 27th (one day prior to the AFHTO conference).
    • AFHTO will work with the Ministry to target FHTs/NPLCs who may benefit from individualized plans to develop effective governance practices and leadership capabilities.
    • Through the work of D2D, AFHTO will begin looking at the correlation between high performing teams and associated governance structures.

    AFHTO is supporting the development of an ‘ED Mentorship Program’ as a way to provide support and encourage knowledge translation for new EDs and EDs requiring additional guidance.

  • Letter from President: AFHTO submission to Minister on optimizing the value of team-based primary care

    Dear board chairs, EDs and Lead MDs/NPs of AFHTO-member organizations: I am forwarding to you the briefing note AFHTO has produced to inform the Minister and ministry’s thinking as they develop plans for moving toward “comprehensive regionally governed, population-based primary health services for Ontarians.” True to our mission to work with and on behalf of members to provide leadership in supporting and expanding high-quality, comprehensive, team-based primary care, AFHTO has completed a literature review to identify the critical ingredients to gain optimal results from a primary care team, and across a population. In order to inform the Minister and ministry’s thinking as they develop plans, AFHTO’s board of directors has distilled this evidence into a set of principles for optimizing the value of teams, and an initial set of recommendations for moving forward. These are presented in the two-page briefing note. This briefing note is a starting point for further discussion – with AFHTO members, our colleague associations in the Ontario Primary Care Council, as well as MOHLTC – on how to spread access to high-quality, comprehensive team-based primary care. Your input is most welcome. Please e-mail info@afhto.ca to submit your thoughts on this briefing note and where we need to go from here. All comments received from members will be considered by AFHTO’s Physician Leadership Council and ED Advisory Council in their meetings in July. These two groups will also meet jointly in early September, leading up to the annual Leadership Session for all board chairs, EDs and Lead MDs/NPs, immediately before the AFHTO conference in October. We look forward to hearing from you. Sincerely, Randy Belair AFHTO President and Executive Director, Sunset Country FHT (Kenora)

  • MOHLTC letter on changes to Managed Entry process and list of areas of high physician need

    The information below from the ministry was forwarded to Board chairs, EDs and Lead Clinicians of AFHTO member organizations.

     

  • 2015 Ontario Budget: What it means for AFHTO members

    April 23 – The Minister of Finance released the 2015 Ontario Budget, providing a blueprint for government spending for the 2015-2016 fiscal year Retention and recruitment in primary care AFHTO attended the budget lock-up along with our colleagues from AOHC and NPAO.  While we are very disappointed there wasn’t a formal commitment in the budget to address primary care retention and recruitment, we remain optimistic that there’s still an opportunity to move on this issue within this fiscal year. Conversations with Minister Hoskins’ political staff during the budget lockup confirmed the Minister is committed to making progress on this issue in the next few months. This is evidenced by the Minister’s statement earlier in the legislature when he said he’s looking at this issue of retention and recruitment and knows it affects NPs and other health care practitioners. We need to make sure MPPs remain aware of this issue and the urgent need for action to resolve it. All members are encouraged to meet with and/or write to your local MPP. To help you do this, click here to access advocacy tools and resources. Budget overview The key themes in the 2015 Ontario Budget are infrastructure, skills training, business environment, and strengthening retirement security. In the 370-page budget document, 10 pages are devoted to an Effective Health Care System for All (pp.161-170) and another 15 pages on key determinants of health – Renewed Poverty Reduction Strategy (pp.171-177) and Assistance for the Vulnerable (pp.178-185). Health care highlights This is a restraint budget for health care. Annual growth in overall health care spending is cut in half from last year – projected to be 1.2% in 2015/16, then 1.9% in the two subsequent years – well-less than inflation and population growth. The commitment to increase home and community care funding continues. Click here for a 2-page summary of the health care highlights from government relations firm Santis Health. Primary care The Faster Access to Primary Health Care section (pp.163-4) confirms one of AFHTO’s core messages – “primary care is the foundation of a strong health care system.” This section also confirms government’s intent to move toward a population-based approach to primary care. The Budget says, “government plans to continue organizing primary health care providers and teams around the needs of the population across the province,” and “To better align key initiatives, maximize investments and ensure that Ontarians have a health care system that is both high quality and sustainable, the government is moving forward to establish a comprehensive capacity planning framework.” There is no additional funding announced in this budget for primary care; there is just a re-announcement of funds to expand access to physiotherapy in primary care settings. The only new announcement for primary care is that “government is removing the barriers to direct referrals to specialists by nurse practitioners.” This is welcome news that will increase the efficiency of teams and timeliness for patients who need specialist care. Pension plans and compensation As employers, many FHTs and NPLCs are asking about the Ontario Retirement Pension Plan (ORPP).  When it comes to pensions, AFHTO’s advocacy goal is sufficient funding to enable primary care teams to offer the HOOPP plan, as stated in the AFHTO-AOHC-NPAO recommendations for primary care recruitment and retention. HOOPP is the standard pension plan for much of the healthcare workforce, and therefore the ideal for recruiting and retaining staff. As individual employers, members may want to consider the ORPP as an alternative – see pages 138-145 of the 2015 Ontario Budget. The section – Ontario’s Plan to Eliminate the Deficit (pp.203-223) – confirms government’s continuing focus on Managing Compensation Costs (pp.210-213). It states, “Any modest wage increases must be offset by other measures to create a net-zero agreement.” This section announces the launch of Program Review, Renewal and Transformation (PRRT) to “assess outcomes in an effective, efficient and sustainable way …. Using evidence to inform better choices and improve outcomes.” The emerging evidence of the value delivered by team-based primary care – such as through the Conference Board’s FHT Evaluation and our collective work on Data to Decisions – has helped to gain support across the Ministry of Health and Long-Term Care for the need to address the crisis in primary care retention and recruitment. We know AFHTO members will continue to demonstrate and improve the value delivered, and with your contact with your MPPs, we will continue to build the political will to act. To help you do this, click here to access advocacy tools and resources.