Global News has obtained a government memo sent to health care CEOs across Ontario by Deputy Minister of Health Helen Angus about a major restructuring of the ministry.

“Today’s announcement will ensure we are ready to work on the challenges and opportunities ahead,” the memo states.

It is unclear from the memo if any government staff have been let go as a result of the changes.

The provincial government said the “structural changes” will allow the ministry to become “more nimble.”

“Aligning acute and emergency services, bringing hospitals, provincial programs and emergency services together; bringing together community and mental health and addictions services, including integrating youth mental health services; ensuring end-to-end planning and implementation for long-term care homes,” Angus notes in the memo.

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After his election, Premier Doug Ford appointed Dr. Reuben Devlin, a former Tory party president and former Humber River Hospital president, to take the lead on health-care reform.

Next week thousands are expected at a rally on the grounds of Queen’s Park to demand expanded health care and a commitment from the government not to cut funding.

The Ontario Health Coalition is organizing the event and states in its press release that, “The government has no mandate to cut, privatize, engage in mega-mergers of hospitals or other services, roll back gains that were made last year, and other negative proposals that have been floated or implemented since the Ford government took power.”

Below is the full text of the memo.

October 18, 2018

MEMORANDUM TO: CEOs

Local Health Integration Networks

FROM: Helen Angus

Deputy Minister

Ministry of Health and Long-Term Care

RE: Ministry Realignment

Over the last few months, I’ve been working with LHIN CEOs and many other health sector partners to better understand our challenges and opportunities to optimize our strengths.

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We are all committed to a patient-centred health care system that is effective and efficient and delivers high quality care. More than ever, we need to collaborate with all of our internal and external partners. At the local level, LHINs have been working with system partners to organize care around the patient. I believe there is great value in the ministry aligning itself in a way that makes it easier for partners and patients to interact with us.

I want you to be aware of some structural changes announced today that will clarify and simplify lines of accountability and allow our organization to be more nimble and outcome focused by:

• Aligning acute and emergency services, bringing hospitals, provincial programs and emergency services together;

• Bringing together community and mental health and addictions services, including integrating youth mental health services;

• Ensuring end-to-end planning and implementation for long-term care homes;

· Integrating capital, workforce and system capacity planning;

• Aligning the Chief Medical Officer of Health with population and public health oversight;

• Combining public drug programs and assistive devices;

• Better connecting the Provincial Chief Nursing Officer with policy to providestrategic clinical nursing expertise on a broad range of health care policy and transformation initiatives. Aligning our policy, research, and innovation work to ensure patient-focused outcomes; and

• Centralizing the responsibilities for LHIN-managed health services under an Associate aligned with key capacity, workforce and planning functions allowing for end-to-end management of health services for better outcomes and improved integration.

Associate Deputy Minister, Health Services,(renamed from Delivery and Implementation) Melanie Fraser, who recently joined our ministry, will have the following divisions reporting to her:

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1. Acute and Emergency Services led by Melissa Farrell, Assistant Deputy Minister including:

· All branches from the former Health System, Quality and Funding Division.

· Provincial Programs Branch from the former Negotiations and Accountability Management Division.

· Emergency Health Services Branches and the Psychiatric Patient Advocate Office from the former Direct Services Division, led by Executive Director, Alison Blair for a transitional period.

2. Capacity Planning and Capital led by Michael Hillmer, Assistant Deputy Minister on an interim basis, including:

· Health Capital Investment Branch from the former Health Capital Division.

· Capacity Planning and Priorities Branch from the Strategic Policy and Planning Division.

· Health Workforce Planning Branch from the former Health Workforce Planning and Regulatory Affairs Division.

3. Community, Mental Health and Addictions and French Language Services led by Tim Hadwen, Assistant Deputy Minister including all branches from the former Health System Accountability, Performance and French Language Services Division.

· Our ministry has worked closely over the past few months with the Ministry of Children, Community and Social Services (MCCSS), to develop an inventory of mental health services and identify mental health programs that are to be transferred.

· Effective October 29, 2018, Tim Hadwenwill receive staff responsible for child and youth mental health from the Children and Youth at Risk Branch, Policy Development and Program Design Division; Transforming Mental Health Branch, Transformation and Implementation Division; and from the Client Services Branch, Service Delivery Division.

· Mental Health and Addictions Branch (led by Director Patrick Mitchell) from the Strategic Policy and Planning Division will be renamed the Mental Health and Addictions Policy, Accountability and Provincial Partnership Branch andtransfer to this division, along with staff from the Transforming Mental Health Branch and from the Child Youth at Risk Branch.

· The Transforming Mental Health Branch (led by Director Ragaven Sabaratnam) from Ministry of Children, Community and Social Services will be renamedJustice, Forensics, and Supportive Housing Branch and will contain some staff from the Child Youth at Risk Branch.

4. Long-Term Care Homes, led by Brian Pollard, Assistant Deputy Minister. This division will now include Long-Term Care Home Renewal Branch from the former Health Capital Division.

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Divisions reporting directly to me as the Deputy Minister include:

1. Drugs and Devices (formerly the Ontario Public Drug Programs Division), led by Suzanne McGurn, Assistant Deputy Minister. The Assistive Devices Program Branch, from the former Direct Services Division will transfer to this division.

2. Ontario Health Insurance Plan(formerly Negotiations and Accountability Management Division), led by Lynn Guerriero, Assistant Deputy Minister. The Claims Services Branch, from the former Direct Services Division will transfer to this division. Lynn will also be the Executive Lead of the MOHLTC Agency Review.

3. Chief Medical Officer of Health and Population and Public Health, led by Dr. David Williams, Chief Medical Officer of Health, who will now be accountable for all population and public health. To support the daily direction and planning of this division, a new position, Director, CMOH Operations will be created. More information on the staffing of this position will be shared in the coming weeks.

4. Strategic Policy and Planning, led by Patrick Dicerni, Assistant Deputy Minister. This division will include the Provincial Chief Nursing Officer and the Health Workforce Regulatory Oversight Branch from the former Health Workforce Planning and Regulatory Affairs Division. The Health Innovation and Strategies Branch (formerly the Chief Health Innovation Strategist), led by Jovan Matic, Director, will transfer to this division to embed innovation earlier in the development of our strategic direction.

5. Corporate Services, further to the announcement that Justine Jackson will be leaving the OPS to join the Centre for Addiction and Mental Health Foundation, Peter Kaftarian has been appointed to the CAO role on an interim basis.

6. Secretariat for Ending Hallway Medicine, led by Fredrika Scarth, Director.

7. Associate Deputy Minister and Chief Information Officer, led by Lorelle Taylor along with her three divisions.

8. Communications and Marketing, led by Jean-Claude Camus, Assistant Deputy Minister.

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As we transition, Sharon Lee Smith, Denise Cole and Roselle Martino will stay on with the ministry on assignment to support priority areas. Sharon Lee will lead the ministry Indigenous engagement efforts ensuring there is stability in our key relationships and addressing any critical issues. Denise will lead the ministry in setting up an expedited review of legislation and regulation to identify impediments to more effective and efficient operations of the health system and the ministry in its oversight role. Roselle will continue to advise on the opioid strategy.

Included in this email is a link to our neworganizational chart.Today’s announcement will ensure we are ready to work on the challenges and opportunities ahead. Thank you for your partnership and collaboration.

Sincerely,

Helen Angus