Remarks by:
Lynn Dollin, AMO President and
Deputy Mayor, Town of Innisfil

Thursday, November 16, 2017
Standing Committee on General Government
Committee Room 2
Main Legislative Building, Queen’s Park


Bill 160, Strengthening Quality and Accountability for Patients Act, 2017

(Check Against Delivery)
 

AMO is here today to seek amendments to Bill 160.

Municipal governments are employers, not stakeholders, delivering the ambulance, public health, and long-term care services and co-funders.  Our concerns emerge from this role and responsibility.
 
Our key concern is that this Bill opens the door to the fire-medic model despite our strong objections. We, along with those in the medical community, have strongly opposed this.  There remains no demonstrable evidence that says patient care substantively improves given the additional training, care oversight, and labour law impacts that this Bill invites.

The Ministry is ignoring the position of the ambulance service employers.  The legislation will allow fire fighters certified as paramedics to treat low-acuity patients through pilot projects.  These pilots are to be hosted by only willing municipalities.

It is the ‘willing’ aspect that is also of concern.  Why – because we saw 24–hour shift pilots were imposed by arbitrators across Ontario despite the employer’s non-supportive position.
 
Based on that experience alone, AMO demands absolute clear legislative protection that makes this out of scope for arbitrators.
 
Our submission contains our proposed language for the amendments.  We’ve been told that all party support is required to make this change as it involved different Acts than Bill 160 opens.

If this Committee accepts that fire-med service is a decision of municipal governments, then you must agree with us to make it clear and ensure that unelected arbitrators do not have the authority. Municipal governments are looking to this Committee to make this fix.

If we saw the same effort on improving dispatch as we have seen on the fire-med matter, we’d have improved patient outcomes now – across Ontario.  

Concerning the changes to Long-Term Care Homes Act, we can all agree on the importance of compliance inspection program and enforcement tools
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Yet, there are systemic issues and factors outside the control of municipal home operators, which can impact the ability to be in compliance. There are shortages of nurses and personal support workers to meet staffing and legislative requirements – often more acute in rural and northern areas.  Success in meeting the needs of residents means there must be corresponding investments by the government in the long-term care sector.

AdvantAGE, which represents both non-profit and municipal homes in Ontario is proposing amendments.  Given my time, I will highlight the offence provisions on officers of Long-Term Care Homes will be higher than those serving on boards of public hospitals.  You need to revisit this.
 
The HPPA amendments to permit the regulation of recreational water facilities and personal service settings is reasonable.  However, the amendment is setting up another unfunded mandate for compliance work by municipal public health inspectors.

There is already tension in the public health system in that the funding is just not adequate for public health units to meet their current obligated requirements.  Municipal governments are on average are providing 38% of the financial support for public health mandatory programs even though we are only required to provide 25% of the funding. We are filling a gap that is not sustainable especially in light of the cumulative impacts of many other pieces of legislation before the legislature.

Thank you for your attention.  I would be happy to answer any questions you may have.