Attention All supporters of the Public/Community Health System in Ontario:
The provincial government has recently established a Nursing Task Force
(NTF) to review access to nursing services, identify changes in nursing
services resulting from health system reform and other factors, and assess
the impact of these changes in the delivery of health services.  The NTF is
expected to deliver its final report to the Minister of Health in December
1998 with "recommendations that will ensure and enhance the quality of
patient care through the effective use of nursing resources within the
current and future health care system."
The NFT is accepting submissions from interested organizations and
individuals until Nov 4, 1998. The Community Health Nurses Interest Group of
the Registered Nurses Association of Ontario is urging all subscribers to
submit a letter or  report supporting the value and importance of visiting
nursing services within the home care system and/or the contribution that
public health nurses make to their communities.

For visiting nurses key issues relate to:
the managed competition process for provision of services through the CCAC's
and the impact on quality and continuity of care;
the negative impact of insufficient funding to ensure access to nursing
services to meet the needs of individuals, particularly those being
dischaarged from hospital sooner and without the necessary supports;
criteria for qualification for services through CCAC's specifying that the
person must have exhausted all available support from family and friends
before they can access funded services;
capping of funding envelopes to the CCAC's and budgetary increases that have
yet made their way to the community, many individuals/families are paying
out of pocket in order to obtain the necessary supports.

Within public health key nursing issues are:
Significant decrease in numbers of public health nurses over the past ten
years (ranges from 20 - 45% of positions lost depending upon the health
unit);
Shifting of funding from the provincial government cost-sharing with
municipalities to a totally municipally funded public health system (The
ministry only pays for vaccines that ph units distriburte to physician's
offices);
Segregation of the public health system from the acute care system leading
to greater fragmentation of the continuum of health care services;
Some programs that are more"sensitive" such as sexual health services
including birth control and STD clinics, HIV testing are particularly
vulnerable to loss of support in some communities;
revisions to the mandatory programs and services guidelines that identifiy
the programs that health units are expected to provide were revised by the
province just prior to the funding shift.  Many services that were available
in the past have been dropped - especially those reaching vulnerable
populations and individuals and families that would benefit from supportive
interventions and teaching from a PHN - in favor of almost exclusive focus
on broad based community wide strategies;

This represents just a few highlights of issues that could be addressed.
We are calling on our nursing and non-nursing colleagues and friends to
support our work and to speak out on behalf of the community regarding the
value and importance of access to community & public health services.

The request  for submissions asks for a report with a summary of no longer
than 2 pages (I'm assuming the page limit is for the summary, not the whole
report; even a letter from supportive community stakeholders would be
worthwhile).
Submissions can be made to:
Ms. Caroline Abrahams
Project Manager
Nursing Task Force
Ministry of Health, Integrated Policy and Planning
8th Floor, Hepburn Block
80 Grosvenor Street, Queen's Park
Toronto, ON M7A 1R3

PH 416-327-8434
FX 416-327-8879

email: [log in to unmask]

Please pass this along to anyone who might be involved with other groups,
post on other list-servs, etc. Many phns work in coalitions in their
communities. Please raise the issue with them if you believe it is
appropriate and if they feel comfortable writing letters of support, that
would be great. If they can meet the deadline great; if not, letters/reports
that they get, will still be of benefit, particularly if they come from
community members.

Thank you for your interest and support.
If you wish to discuss this please contact Adeline Falk Rafael Chair of the
Community Health Nurses Interest Group at [log in to unmask] . Copies of
any submissions would be appreciated and can be sent to Adeline as well.

Joyce Fox
[log in to unmask]