Those who said that the Ford government in Ontario would bring in the kind of tumultuous era that came about when the Mike Harris government ruled the roost in the late 1990’s, might be saying I told you so about now.
Under Harris, the delivery of health, education, social and municipal services in Ontario all saw radical changes. Under Ford, the same thing is happening.
The 14 Local Health Integration Networks LHINS, which fund hospitals, homecare and other health services, are being folded into a single agency. That was not a huge shock to anyone. The LHIN’s, a Liberal government innovation, were never very popular and the Conservative Party said they would eliminate them while on the campaign trail last spring.
The subsequent plan to eliminate dozens of health care and community support agencies in order to set up single service providers for populations of 300,000 or so residents signaled the direction the government intends to take, across the spectrum of provincially delivered services.
This week, the true breadth of change is coming even more clear with the announcements that Public Health Units will be restructured. Thirty-two health units will be reduced to 10, each serving a million or so people.
Then, another shoe fell, when it was announced on Monday that 52 Paramedic Service Providers in the province will be restructured down to 10 as well.
As taxpayers, we should be able to hear from our politicians how these changes, with all the up-front costs they will bring, will improve service delivery and/or save money. Before disrupting operations that have been working to create efficiencies and trying to build effective corporate cultures around delivering public services, we all need to know that there is a coherent plan to actually make things work better.
But we have none of that. All we have is this suspiciously round number, 10. There are 14.8 million people living in Ontario, spread in a very uneven fashion over a 1.07 million square kilometre land mass. Somehow, it makes sense to have 10 (not 9, not 14, not 8) but exactly 10 Public Health organisations and the exact same number of Paramedic Service operators.
It might be a coincidence but it suggests that instead of a thoughtful consultative process aimed at determining the best way to deliver essential paramedic services, and promote and defend public health, a small group of political operatives sat around a table and thought 10 was a nice round number.
The Minister of Health, Christine Elliott, put out a statement on twitter on Tuesday, after the story came out, about the changes to Paramedic Services.
“As we modernize our health care system, we will empower paramedics to improve the already great emergency care they provide. We are working with frontline paramedics and our municipal partners to ensure emergency health services can better meet the needs of Ontario’s communities,” she said
The way this has been announced and the fact that no one involved in paramedic services had any idea this was coming, suggests that Elliott’s claim that “we are working with frontline paramedics and municipal partners” is false. If that claim is false, then why should Ontarians believe that the new emergency system will indeed “better meet the needs of Ontario’s communities”.
Later in the day, Premier Ford seemed to step back from what had been a definitive statement of the governments intent to make these changes, by saying “nothing is written in stone” and “we are looking at all options”. This only serves to indicate that this government is willing to make announcements first, and develop concrete policy later.
I might be proved wrong, but I expect that services to more remote regions of our area, such as Denbigh and Robertsville in Frontenac and Lennox and Addington, will face closure when a single service provider, with no local oversight, is responsible for all of Eastern Ontario, from Cobourg to Cornwall in the South and Pembroke to Huntsville in the North.
The implications of this will hit Frontenac County more than just about any other jurisdiction, since losing the Paramedic Services will cut out over 40% of its operating budget.
What this does, as well, is leave municipal politicians to wonder what comes next. The changes to Paramedic Services and Public Health reveal that the provincial government is more than willing to radically change services, that are financed with both provincial and municipal dollars, and operated by municipalities. And in doing so, they will effectively be taking over the services.
There is an example of how this works, the operation of the OPP. Municipal ratepayers pay for the service through property taxes, but municipal councils have no say in either the operation of the service or how much it costs their ratepayers. All of the control rests with the Province.
It is becoming more and more evident, that the next change that is coming will involve a restructuring of Ontario municipalities themselves.
Should we be getting prepared for the 10 municipalities solution in Ontario?
Kieran Moore, the Medical Officer of Health For Kingston, Frontenac, Lennox and Addington, is concerned about radon gas, seeing it as a major public health risk.
Radon is an odourless, colourless gas that that is produced by the decay of uranium found in rocks, soil and water. Buildings that are constructed on substrates with high concentrations of radon can create a draw for the gas, which seeps in, and can concentrate in the ground floor, and especially in basements. It does note readily migrate to the upper floors of houses, and is most prevalent in basements, but can be circulated through houses through heating and air-conditioning systems.
It is a major causal factor in the development of lung cancer, having been shown to be responsible for 16% of lung cancer deaths in Canada, according toa report called Radon: Poilcy Considerations, that was presented to members of the Board of KFL&A Public Health in October.
It is the second most deadly environmental carcinogen in Ontario, according to a report published in 2016 by Public Health Ontario and Cancer Care Ontario. Between 1090 and 1550 lung cancer deaths in Ontario are attributable to radon exposure each year. The most deadly environmental carcinogen is the solar UV radiation, which is associated with 2100 and 3000 deaths from melanoma each year.
Radon levels vary according to geography, and in the KFL&A region 11% of homes tested contained over 200 Becquerells per cubic metre, the level where human health can be compromised, according to the government of Canada. The provincial average is 4.6%, making the issue of extra concern in KFL&A
“It should be noted,” said Keiran Moore in a telephone interview last week, “that there is no safe level of exposure to radon, and that in Europe the target is set at 100”.
Moore added that he would have thought that “the levels would be higher on the Canadian Shield portion of the region,” but the studies that were done showed as much exposure on the limestone substrate as on the granite.
To put the risk posed by radiation exposure into context, Moore said that continued exposure to radon over time brings the of developing cancer among non-smokers to 1 in 15. The risk for the population as a whole is about 1 in 300 according to an article published in July o fthis year by Dr. Lynne Eldridge on the website Verywell.com.
The lung cancer risk for smokers, which is 1 in 9, is greatly increased when smokers are exposed to radon over time, rising to 1 in 3, according to Dr. Moore.
“Now that our smoking rates are coming down, we are making headway with lung cancer, which is our number one killer” said Moore. “As this happens, radon, the second most important causal factor, is more and more in our sights.”
The report to the KFL&A Board of Health looks at what the health unit can do to begin scaling back the impacts of radon on residents, in our own region and province wide.
“Exposure can be effectively prevented through well-established radon-specific building measures.” which, the report says “are easy to install during the construction process of new homes and costs approximately $500. However it is more difficult to retrofit an existing building and the expense rises to $1,200 to $5,000.”
Dr. Moore said that the first step for residents is to test for radon. There are kits available at hardware stores at a reasonable price. There are short term and long term tests available.
Brooks Gee, a regional manager for Mr. Radon, a mitigation company, said that the long term kits that are available are generally better than the one time kits. He also said that the place to test in a house is the lowest occupied level.
“If the basement is only used for storage and laundry, it is best to test in the kitchen, but if the basement is occupied, I would test there, said Gee.
Gee also said that his experience dovetails with the studies that have found radon is prevalent throughout the region, regardless of whether the substrate is limestone or granite, but “although it is not scientific I would say the 11% figure for high levels is low,” he said.
Currently only 4% of Canadians have had their homes tested.
Homeowners who are living in homes that are less than 7 years old should test immediately, because through the new home warranty act, Tarion covers 100% of the cost of mitigation for radon for the first 7 years.
Public Health will be advocating for changes to the Ontario Building code requesting that radon specific building measures be adopted in the code when it is amended next year,.
But municipalities need not wait that long.
According to the policy report, Public Health can pursue “advocating to municipalities in our region to adopt radon-specific measures in the National Building Cose as bylaws, in the way that it is done in the City of Guelph, Central Elgin, St. Thomas and Thunder Bay.”
Other immediate measures that can be taken are testing all schools and daycares for radon, and the report also urges the Board to advocate that the threshold be lowered to 100Bq/M³ from 200Bq/M³ to bring Canada in compliance with the threshold level that is recommended by the World Health Organisation.
Starting in the new year, the KFL&A Public Health should pursue a “multipronged strategy to reduce radon exposure for residents in the KFL&A region. These efforts are an investment towards achieving an enduring reduction in the rate of radon-related lung cancer deaths in our region,” the poluicy report concludes.
Dr. Moore said that in response to the report, he made a “promise to the board to come up with concrete best practices. I hope over the next six months we will be able to have the best practices in play. We are bringing in provincial and federal experts to do this.”
OAHS brings in mold-Busters
Five weeks ago Danielle Pollard of Kaladar moved out of the home she has lived in with her young daughter since early in 2014 after finding that mold had developed throughout the upstairs portion of the house.
As reported in the Frontenac News on October 23, Ms. Pollard lives in a rent-subsidised house that is administered by Ontario Aboriginal Housing Services (OAHS).
The article outlined how Ms. Pollard received an opinion from the KFL&A Public Health Unit, which indicated that all porous materials in the home should be replaced, including the wooden furniture, sofas, etc. At the time that the article was written, the results of an air quality test had not come in yet.
A phone message to Cory Smith, of the client services department of OAHS in Peterborough, was not returned before the article was published.
Subsequent to the article being posted online, on October 24 an email from Kelly Reynolds, communications co-ordinator at the OAHS head office in Sault St. Marie, came to the News. The email included a statement from Don McBain, executive director of OAHS. It reads, in full:
“OAHS has been working in collaboration with Mrs. Pollard and independent contractors to have her concerns regarding mold addressed. A Health Inspector visited the unit and the report was provided to Mrs. Pollard on October 3. This report did not indicate the home was unsafe to live in and indicated specifically which furniture items were to be cleaned with soap and water, removed or replaced. Mold was not reported to have been found on the shell of the unit. Air quality tests were performed and sent to a third-party laboratory for inspection. We anticipate results of this independent Air Quality Report sometime today. Mrs. Pollard was notified that OAHS would not move forward with remediation until results and recommendations are received. Records do not indicate that the unit had mold issues in the past. OAHS has been active in addressing this complaint and will continue to work with this client to ensure this unit meets all Health and Safety requirements.”
When interviewed earlier this week, Don McBain confirmed that the air quality test referred to in the email was received by OAHS on October 27.
The test indicated a very high reading for a category of mold called Asp/Pen (Aspirgillus and Penicillium). The reading inside the building was 60,800 in what is called raw data and 3.24 million spores per cubic metre.
It was hard to find online information about what a safe level for Asp/Pen is, but one web site we consulted said the raw count for Asp/Pen should be in the single digits, and another, Inspectapedia, said a reading of 36,000 per cubic metre indicated a “mold-damaged building”.
This week, Don McBain acknowledged that the mold readings are “very high”. He also said that indications are that the building is not contaminated with mold, and that the cause of the problem is poor ventilation.
The health hazards of Asp/Pen, which is a category including a number different varieties of mold, vary from individual to individual. They are allergens which can cause reactions such as sneezing, itching wheezing etc, and they can be more serious for asthma sufferers, and even fatal for those with suppressed immune systems. People working on cleaning up Asp/Pen contamination are instructed to wear respirators.
A Kingston-based company, mold-busters, was contracted to come in this week to do a remediation.
According to an email sent to Danielle Pollard by Cory Smith, the remediation will proceed in two phases.
“The good news is that since the mold exists on the surface, it can be disinfected and demolition will likely not have to take place. Therefore, according to Mold Busters, remediation should take one day. They will be disinfecting all surfaces, drapery, and ventilation systems to ensure a complete removal,” he wrote. “As far as preventing future growth, Mold Busters will be providing the unit with an air extractor/dehumidifier.”
Once the remediation is done the air will be tested again and if it is declared mold-free the OAHS will consider the matter to have been dealt with.
As far as the status of the wood furniture and sofas in the house, which KFL&A Public Health said could not be cleaned, Don McBain said Mold-busters does not take the same view.
“They are capable of determining what needs to be done and if they decide things need to be removed they go ahead and do that,” he said.
When asked about compensation for Ms. Pollard, who has not been living in her rental house for five weeks and counting, and might be dealing with the loss of furniture and other items, McBain said that those matters will be taken into account.
This leaves Danielle Pollard in a bit of a quandary. What should she do if Mold-busters says her furniture can stay but Public Health has condemned it as contaminated.
“If Mold-busters says it is safe, should I put my daughter in her bed, knowing that Public Health says it should be thrown out?” she wonders.
When contacted, Matt Doyle from KFL&A Public Health confirmed that in the view of his agency, all porous surfaces, including wood, cannot be decontaminated. As far as the claim by OAHS that he “did not indicate that the house was unsafe to occupy,” Matt Doyle said that does not mean he said the house was safe to occupy, only that he did not comment on that issue since it was outside of the scope of his investigation.
Ontario Aboriginal Housing Services owns and operates a number of houses in the Frontenac News readership area. They are available to the entire population on the basis of a needs assessment. Referrals are made through community services agencies, local First Nations and the Métis Association.
The Greenstreet family, which owns the former gym at Highway 7 and Clement Road, as well as Goodfellow's Flowers and a wine-making store that are operated by Michelle Greenstreet, has been in a two-year battle with Kingston Frontenac Lennox and Addington Public Health over the testing requirements for water at the gym, which the Health Unit classed as a commercial water system when they first visited the facility on April 19, 2012.
According to Rick Greenstreet, who lives upstairs from the gym, which was being operated by his daughters Nicki and Michelle, the health unit inspector, Joan Green, said at the time that since there was no data about the well at the site, monthly testing would be required at a commercial lab at the gym's expense.
In response, the Greenstreets disconnected the sink in the bathroom of the gym and replaced it with a towelette station.
“But that wasn't good enough because the toilet was still there and people could possibly drink from it, according to the health unit,” said Rick Greenstreet.
The last dealings the Greenstreets had with KFL&A Public Health at that time were on May 22, 2012.
“We officially closed the gym, and made it a residential space. I am permitted to run a karate club out of my own home, which I do in that space. My daughters teach classes to local kids twice a week. The kids are all members of the club and they are all registered with my insurance company,” he said.
In addition, he said that the toilet in the gym was removed and the kids who attend classes drink water from a rented cooler and go to the bathroom outside.
On June 26, 2012, the Greenstreets received a letter from Joan Green saying they were non-compliant with water regulations.
“I told them the space was a private rec-room and it has no water and if they wanted to check it out they could get a warrant,” he said.
Nothing happened for over a year.
Then, on August 12, 2013, another similar letter arrived, this time from Joan Green's supervisor, Ed Gardiner. Rick Greenstreet sent the same response. Again, nothing happened.
Then last week, on April 2, the Greenstreets were served with a court order from Tausent Freund, a Kingston-based Ontario Supreme Court Judge, ordering water testing under threat of a $25,000 fine.
“We were never informed about the court hearing and thus had no opportunity to point out to the judge that there is no water to test in that location and that it is a private space,” said Greenstreet.
The matter is now in the hands of the Greenstreets' lawyer, James Bond of Perth.
Another year, another request from Pine Meadow; same result
Bud Clayton, the Chair of the Management Committee for Pine Meadow Nursing Home, which is owned and operated by Land O'Lakes Community Services, made a presentation to Frontenac County last week (January 20)
Each year for several years, a board member from Pine Meadow has made the trip down to Glenburnie to ask for support from Frontenac County towards upgrades to the home.
The logic behind the request, as Clayton pointed out, is that although Pine Meadow is located in Lennox and Addington and is not part of the municipally-run long-term care sector, 21 of the 60 beds in the home are currently occupied by residents of Frontenac County.
“On behalf of those 21 folks in Frontenac County, I am here making a modest request to help us complete some of the necessary upgrades to the home. We would like to truly fulfill our partnership with Frontenac County,” said Clayton.
Clayton asked for a commitment of $25,000 per year for 10 years, the same amount that has been committed to the home by Lennox and Addington County.
Clayton pointed out that Pine Meadow is waiting to hear from the Ministry of Health and Long Term Care through the Local Health Integration Network (LHIN) about expansion and upgrade plans for the home, which would make it larger and bring it up to the provincial “A” standard for nursing homes.
Currently Pine Meadow has a number of four-bed, ward-style rooms, while the “A” standard calls for one and two-bedroom suites for residents.
Pine Meadow is also preparing to take a larger role in providing service to the general public by establishing dialysis and physiotherapy services for residents and the general public, all overseen by a nurse practitioner who has joined the Pine Meadow staff.
“There are three families in Ardoch that travel to KGH for dialysis treatments. This is inconvenient and costly. Our dialysis unit will be an asset to Frontenac County,” Clayton said.
“I think Council knows my feelings on this subject,” said North Frontenac Mayor Ron Maguire after Clayton's presentation. “The amount requested is the same amount I am requesting. I think given the vastness of Frontenac County we need to support a home that serves such a large portion of our population.
While none of the other members of the four-member county council said much after Bud Clayton's presentation, there was more of a response at a county budget meeting this past Monday, January 25 when Ron Maguire attempted to have the $25,000 request added to the Frontenac County budget.
Central Frontenac Mayor Janet Gutowski said she had “mixed feelings about the request. I recognise the emotions and the affection for the Pine Meadow. I hesitate, however. We are deciding whether people are being taxed for it. I know it is a not-for-profit but it is not a government facility. They hire a company to manage it, to do the books and the accounting. I don't have the same level of comfort for the facility that I do with Fairmount Home. I also have a concern that we really need additional facilities within our own county. We are looking at $250,000 over 10 years. If that money could be put towards a feasibility study to look at population and development statistics and demographics to see if we could attract a private investor for that kind of project.”
Frontenac Islands Mayor Jim Vanden Hoek said, “I’m not taking away from projects that people would like to support, but I’m concentrating my efforts on trying to decrease the county levy to the member municipalities. That would free up money for them to make investments in projects like this.”
County Warden Gary Davison said, “At this point I don't feel I can support this.”
County staff were not directed to add $25,000 for Pine Meadow to the 2010 budget, which will be the subject of a further meeting on February 1.
Planned Public Health pull out from septic inspections questioned
Members of Frontenac County Council took advantage of a visit by Doctor Ian Gemmill, the medical officer of health for Frontenac and Lennox and Addington County to question the direction of the KFL&A Public Health in terms of septic inspections and approvals.
“I have concerns about septic inspection,” Frontenac Islands Mayor Jim Vanden Hoek told Ian Gemmill.
Frontenac Islands Council passed a resolution in December, which asked Public Health “to postpone any decision on vacating the septic approvals process until we assess any implications to [our] municipality”.
This resolution has since been supported by the other three Frontenac County townships.
As Dr. Gemmill pointed out, septic approvals have been done by Public Health for member municipalities on a contract basis ever since municipal amalgamation in 1998. “Before 1998 septic inspections were governed under the Ministry of the Environment and it was within the mandate of Public Health to do them, but in 1998 they became part of the building code. My predecessor was very clear that he wanted this program to continue to make sure septic inspections were done well,” Dr. Gemmill said. “We've done this with fees that are lower than the provincial average.”
But after 11 years Public Health is reconsidering its role. “We had a retirement last year, and our new manager wanted to have a look at this,” he said.
One of the issues that was looked at was cost. Although the inspections are a cost recovery program, “We were concerned that there is some subsidy of this program, and we like to see our budgets kept clean,” Gemmill said. He also pointed out that Public Health faces added responsibilities under the Safe Drinking Water Act and would like to focus their attention in that direction.
Of 34 public health organizations that have the option of offering septic inspections or not, only six offer the service, Gemmill said.
Ed Gardiner, a Public Health Manager, has approached the municipalities that use the service, and according to Dr. Gemmill, “The feedback was not to do this in too fast a way.”
A meeting with municipal officials was held a couple of weeks ago and according to Gemmill, “around the table all parties agreed that if this were phased out by the end of 2010 it would be satisfactory to them.”
He also said that local conservation authorities are prepared to offer the service for those municipalities that do not want to take the service in house.
“This is the most visible service that our residents see from your agency,” Vanden Hoek responded. “We have trouble maintaining a building inspector as it is. We do not believe Public Health has the authority to do this. This is going to take some time, more than 2010.”
Central Frontenac Mayor Janet Gutowski has represented Frontenac County on the Board of KFL&A Public Health for the past two years. She pointed out that while Public Health staff have been in communication with the townships about plans to pull out of the service, the Public Health board has received no formal report on it.
“There is a report in our agenda package for the meeting we have scheduled this week,” she said, “ I do not think it includes enough background. It does not refer to the correspondence that has come in from the municipalities on this, and the question of the municipal capacity is not considered either. If a resolution on this comes forward at this time, I certainly will not support it.
I'd also like to suggest that although some of the background to this touches on financials, I have never seen any financial detail attached to it.”
“Thank you very much for the vote of confidence about the job we've been doing on the inspections,” said Doctor Gemmill. “It's not that our agency wants to leave people high and dry. If this is not done in 2010, so be it.”
County makes little progress on budget
The budget process at Frontenac County in recent years has been a matter of moving through the various departmental budgets, which are each on a separate page, flagging those that need to be debated and crossing off those pages where there are no problems.
In this way the budget debate ends up focusing in on narrower issues over time, leaving a couple of loose ends to be mulled over or argued over.
And then the budget is finalised.
It's been a different case this year.
Not only have there been questions about several of the planned expenditures, there has also been a preliminary question that has not been resolved. It has to do with $793,000, a windfall for the county that came from the provincial uploading of costs for the Ontario Disability Support Program.
The way the budget that had been presented to county council is set up, that money is noted, but it is offset by other expenditures. Included in those expenditures is a $350,000 payment to a reserve fund to offset money that was used to balance the 2008 budget.
The resulting budget calls for an increase in taxes of only 2%, but an increase in county spending of over 13%.
The problem, at least in the view of county councilors Jim Vanden Hoek from Frontenac Islands and Ron Maguire from North Frontenac, is they would like to have seen that $793,000 transferred to the local municipalities to be used on road and bridge projects. Vanden Hoek sits on the board of the Association of Municipalities of Ontario. “I know that when AMO argued that the province should take back those ODSP costs, the money was to go to roads and bridges. Somehow in this discussion, that $793,000 has to go to roads and bridges, and that would have to be through a flow through to the lower-tier municipalities,” Vanden Hoek said.
North Frontenac Township had already requested, in the form of a resolution to county council, that the money be transferred to the townships.
In spite of Vanden Hoek's comments, no direction was given to county staff to make changes to the budget as the result of the ODSP savings.
Instead, several items in the budget were flagged for further debate. Those include a $40,000 increase in the budget for staff training, $100,000 that is earmarked for a comprehensive review of social services within the county, $25,000 for a “business continuity plan” for the Emergency Services department, and $25,000 for upgrades to the Frontenac Room, where council meetings are held.
A report recommending that county staff receive a 2% cost of living salary increase in 2010 was also deferred, pending budget debate.
County Council has one more budget debate scheduled, on February 1.
(See Editorial – A lack of Political Direction)