Health Policy Committee

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Health Policy Committee Jeff Kolbasnik (Acting Chair) Greg Athaide Atul Kapur Rachel Kupets Kamila Premji Carlisle Whitby Ottawa North York Ottawa Joanne McNamara Dara Laxer OMA, Chief, Advocacy & Public Affairs OMA, Director Health Policy & Promotion 1

Policy Responses Legislation/Regulations Submissions Fitness to Drive Safe Access Zones Breach Notification Requirements Patients First Act Bill 160 WSIB Chronic Mental Stress Policy Public Health Within An Integrated Health System Submission HPRAC Consultation: Controlled Act of Psychotherapy 2

CPSO Submissions Medical Records Maintaining Appropriate Boundaries and Preventing Sexual Abuse Ensuring Competence: Changing Scope of Practice and/or Re-Entering Practice Physician Services During Disasters and Public Health Emergencies Changing Scope of Practice - Expectations of Physicians not Certified in Emergency Medicine (EM) Intending to Practice Emergency Medicine in Rural Settings 3

Recreational Cannabis: Submission made to the Ministry of the Attorney General: Developed using a harm reduction approach with focus on recreational cannabis that is smoked Total of 21 recommendations, with the first recommendation advocating to abstain from recreational cannabis use Issue OMA Position / Recommendation Bill 174 / Government Announcement Alignment Minimum Age Minimum age to use, purchase and possess recreational cannabis should be set at 25. Minimum age to use, purchase and possess recreational cannabis in Ontario will be 19. Not aligned Place of Sale Where Cannabis Can Be Used Protecting Public Safety (Road Safety) Recreational cannabis and related products should be sold through a Crown Corporation that has a monopoly on the retail and distribution of cannabis and related products throughout the province. The distributor of cannabis should not be able to sell other products, such as alcohol or tobacco. The Ontario government should prohibit smoking cannabis in certain public and private spaces, following smoking tobacco restrictions. The Government of Ontario should develop: Comprehensive safety framework around impaired driving Police training to capture changes to legislation, as well as education around the identification of impaired drivers. Public safety campaign aimed at cannabis users that are pedestrians or cyclists. The OCRC will oversee the legal retail of cannabis in Ontario through new stand-alone cannabis stores and an online order service. Ensure there will be only one legal retail distributor for cannabis in Ontario and alcohol and cannabis are not sold alongside each other. It will be illegal to use recreational cannabis anywhere other than a private residence. Consumption of recreational cannabis will be prohibited in public places, workplaces or when inside a motor vehicle. Proposed amendments to the Highway Traffic Act to outline stricter penalties for driving under the influence of drugs. Aligned Government has proposed stronger restrictions on where cannabis can be used. -Government has outlined stricter penalties for driving under the influence -OMA recommendations focus on education. 4

Hospitals and Health System Funding OMA Hospital Issues Committee continues to work on: Joint OMA/OHA Physician Hospital Issues Committee -Joint policy development and member education where possible Health System Funding and Hospital Funding Formulas: 1. Quality Based Procedures (QBPs) and Quality Standards -Several possible new QBPs for next two years to be confirmed 2. Ministry Pilot Integrated Care, Bundled Payment Models (hospital, community) -Such as: hip, knee, cardiac and COPD 5

Opioids: Canadian Medical Association Position Policy on Harms Associated with Opioids and Other Psychoactive Prescription Drugs recommends a comprehensive national strategy Advocates for: Enhancement of optimal prescribing through evidence-based guidance Education and support for prescribers Enhancement of optimal prescribing through physician regulation and prescription monitoring programs Increase in access to treatment for pain Increase in access to treatment for addiction Increase in information through epidemiological surveillance Prevention of deaths due to overdose Provision of information for patients and the public 6

Opioids: OMA Policy Considerations Endorse CMA position on opioids and other psychoactive prescription drugs; support appropriate prescribing to ensure safe prescribing of opioids; Emphasize importance of taking a harm reduction approach to ensure adequate training and resources are available for the public as well as healthcare providers; Compile supportive resources for training and education, and identify gaps in such resources; Advocate for system level real-time prescription monitoring program; and Advocate to system to deliver additional funding on an emergency basis to significantly expand the availability and access to addiction treatment and pain management services. All while advocating to ensure physicians are safe and protected while supporting patients. 7

Opioid: Polling Questions 1. Do you support the OMA endorsing the CMA policy position on opioids? (Y/N) 2. To better support physicians during the opioid crisis, what other educational supports and resources do you need? A) Patient education B) Prescribing guidelines for acute and chronic pain management C) Additional CME accredited education sessions D) All of the above E) Other, please use free text function. 3. Should OMA be advocating for alternative treatments? (Y/N) 4. Using free text, share your ideas. 8

Upcoming Work Improving referrals/ consult reports Prescribing Drug Policy Proposed Scope of Practice Changes ehealth Regulations Role of non-physician health-care providers in primary care Offering improvements to CPSO Complaints Process 9

Comments/Questions? 10