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SHELTER FROM THE STORM

- Local Health Unit Works With Other Care Providers to Respond to Health Needs of Newly-Arrived Syrian Refugees -

(PORT HOPE) – Responding to the health care needs of Syrian refugees settling in this area has so far amounted to a “trickle” for local Health Unit staff, amidst the wave of new arrivals coming to Canada.

To date within the local Health Unit’s region that includes Northumberland County, Haliburton County and the City of Kawartha Lakes, nearly two-dozen Syrian refugees have been welcomed in Cobourg, Lindsay and Bobcaygeon. While more refugees – both those privately sponsored and government-assisted – are expected to arrive locally in coming months, the demand on public health services has so far been minimal, members of the Board of Health for the Haliburton, Kawartha, Pine Ridge District Health Unit were told at their monthly meeting on February 18.

“We have not seen a huge influx of Syrian refugees in our area, and as a result, the impact on our services has just been a bit of a trickle,” said Anne Marie Holt, Director of Communicable Disease Control, Epidemiology and Evaluation with the HKPR District Health Unit. “As more Syrian refugees come to this area, there may be increased demand for our services.”

Holt was updating Board of Health members on the Health Unit’s role in supporting and responding to the health needs of newly-arrived Syrian refugees. The support provided to Syrian refugees is very much a coordinated response involving other local health care providers and various levels of government, she noted.

Before coming to Canada, Syrian refugees undergo a thorough medical examination and screening, Holt explained. If a disease like tuberculosis (TB) is detected, individuals are treated prior to coming to Canada. Upon their arrival in Canada, Syrian refugees are met at the airport by medical teams that can provide clinical care for immediate health needs. Once the refugees move to their new communities in Canada, local health care providers will then work to respond to additional care needs.

Locally, the Health Unit is working with other care providers to review – and translate – the vaccination records of Syrian refugees to ensure all their immunizations are up-to-date, Holt told Board of Health members. Because health care in Syria has deteriorated significantly since the start of the civil war five years ago, many Syrian refugee children born since the conflict started have never been vaccinated against any disease. “In those cases, we start vaccination from scratch,” Holt noted.

Health Unit staff will also follow up with Syrian refugees who were treated for TB overseas to ensure they remain disease-free in Canada. While rates of TB infection among Syrian refugees are relatively low compared to other countries where TB is endemic, Holt notes the Syrian TB rates are slightly higher than the overall TB rate for Canada.

The Health Unit has also provided quit-smoking resources in Arabic to recent arrivals from Syria, and are able to assist Syrian refugees in accessing financial-assistance programs that can cover and offset the cost of dental treatment. Nurses with the Health Unit are also working with private sponsors and other groups to ensure Syrian refugees are linked to the right services to get them properly settled in their new surroundings.

In response to a question from a Board of Health member, Holt said that the mental health needs of newly-arrived Syrian refugees are still unknown. “Only time will tell what the mental health impacts on our system will be,” she said, noting many refugees arriving in Canada have suffered extreme trauma and seen unspeakable horrors during the Syrian civil war.

Opposition to ‘Patients First’ Proposal:
The local Board of Health has come out strongly against proposals included in a Patients First discussion paper, warning the changes could undermine local public health programs and services.

Board members unanimously approved recommendations calling for the provincial government to rethink its plans that would change how Ontario health units are funded and held accountable. In December 2015, the Ontario government released a discussion paper entitled Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario. The Patients First document proposes a closer integration between health units and Local Health Integration Networks (LHINs). Under the proposal, health units would work more closely with LHINs to plan population health services. LHINs would also assume control over provincial funding for health units and their accountability agreements with the province.

While open to a closer working relationship with LHINs, the local Board of Health’s recommendations are unequivocal in stating that funding and responsibility for accountability agreements with health units should remain with the Province – not the LHINs. In the event LHINs are given more control over health units, the local Board of Health is calling on the Province to ensure funding for health units is maintained and not redirected by the LHINs to other health services.

In a report to the Board of Health, local Medical Officer of Health Dr. Lynn Noseworthy noted that the work of Ontario health units is not focused on treating patients who are sick, but rather keeping the community as a whole healthy and free of disease. “Public health’s mandate is health protection, disease prevention and health promotion, and its focus is primarily population health,” Dr. Noseworthy’s report stated. “Most of our work addresses population health and is ‘invisible.'"

Examples of the Health Unit’s work include inspecting restaurants and other food premises, promoting infection control practices, monitoring and following up on disease outbreaks, tracking vaccination rates among school-aged children, investigating animal bites for possible rabies exposure, providing dental screening for students in local schools, and raising awareness about avoiding illness. In much of what it is does, Dr. Noseworthy noted that health units work with other partners including municipalities, school boards, health care providers and other agencies.

The community partnerships forged by health units, and their work to prevent diseases and promote health, could be undercut by the Patients First proposal, Board members agreed.

The local Board of Health is not alone in raising flags about the Patients First proposal. Other health units in Ontario, including Toronto and Durham Region, have also expressed concerns about the proposed changes.
Medical Officer of Health Updates:
Dr. Lynn Noseworthy provided information to Board of Health members on the following:
Tenants’ Legal Liability
The Health Unit is increasing its tenants’ legal liability insurance in 2016, to reflect higher building replacement costs and other potential liabilities. The increased coverage will amount to an increased premium of $4,300 per year.
Safe Communities Northumberland
Over the past several months, Health Unit staff have been working to support Safe Communities Northumberland. The initiative was officially launched in April 2015 with the aim of promoting safety and preventing injuries in Northumberland County.
Strategic Plan Priorities
Work continues on the Health Unit’s strategic plan, including three main areas of emphasis: mental health, communication and the social determinants of health.
Emergency Preparedness
The Health Unit will hold a mock exercise on March 31 to test its continuity of operations plan in the event of an emergency.

Reports
Healthy Smiles Ontario Update
Oral Health Promoter Anna Rusak provided Board members with an update on the newly integrated Healthy Smiles Ontario (HSO) program. As of January 1, 2016, the new HSO took effect to streamline the administration and delivery of publicly-funded dental programs.

The integration affected the former HSO program, Children in Need of Treatment Program, oral health preventive services provided by Ontario health units, Ontario Works, Ontario Disability Support Program, Temporary Care Assistance, and Assistance for Children with Severe Disabilities Program. There are three enrollment streams for the new HSO program as follows:
• Core Program (HSO)

• Preventive Services Only (PSO)

•Emergency and Essential Services Stream (EESS)

Under the new HSO, families with dental insurance are now eligible for assistance through the program. Another upside to the new program is that all local children will now be able to receive free fluoride applications from the Health Unit, Rusak said.

One major change is that the local Health Unit will no longer administer any of the publicly-funded dental programs it previously did, Rusak explained. However, Health Unit staff will still provide dental screening in schools, at the Health Unit’s office and elsewhere in the community to help determine clinical eligibility for EESS and PSO. Health Unit staff are also available to promote HSO and help local residents “navigate” the new system to see if they qualify for financial assistance, she added.

To obtain more information about the new HSO program, parents and clients are encouraged to contact the Health Unit and speak with staff in the Oral Health Department.
New Business
Health Unit Budget 2016 –The Board of Health approved a $16.7 million budget, which includes regular operating expenses of $16 million, as well as $700,000 in one-time funding requests.

This budget represents a 2.5 per cent funding increase over 2015 for the Health Unit’s three obligated municipalities – Northumberland County, Haliburton County and the City of Kawartha Lakes – and the provincial government. While the Ministry of Health and Long-term Care announced in September 2015 that the Health Unit would receive a zero per cent increase in 2015 and for the foreseeable future, the Health Unit’s Director of Corporate Services, Mary Catherine Masciangelo, told Board members that it was imperative to approve a budget that provides the Ministry with an accurate picture of the funding needing to continue to deliver Health Unit programs and services.

Arriving at this budget, the Health Unit has implemented a number of cost-saving measures, including revisions to the contract with its cellphone provider, reviewing various programs and services and managing staff vacancies.
Operating StatementApproved, a motion to accept the draft operating statement for the HKPR District Health Unit. As of December 31, 2015, the Health Unit had overall expenditures of $18.5 million and finished 2015 with an unaudited surplus of $43,725.

PoliciesApproved, a revision to a number of Health Unit policies.
Correspondence – Received for information, a number of correspondence items from the Association of Local Public Health Agencies (alPHa), Ministry of Health and Long-Term Care, and Public Health Ontario.

Next Meeting

The next Board of Health meeting will be held at 10 am on Thursday, March 17, at the Health Unit’s office (108 Angeline Street South) in Lindsay.

 

For media inquiries, contact:
Dr. Lynn Noseworthy, Medical Officer of Health, HKPR District Health Unit, (905) 885-9100,
or Bill Eekhof, Assistant Communications Officer, HKPR District Health Unit, (905) 885-9100.

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