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Yukon government releases terms of reference for health and social services review

Review panel’s final report will be delivered to YG in March 2020 instead of this October
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Bruce McLennan, chair of the independent expert panel, from left, teleconferences with Stephen Samis, deputy minister of health, Pat Living, health and social services communications, and Whitehorse media on April 15, regarding the scope of the health and social services comprehensive review. (Crystal Schick/Yukon News)

The Yukon government has released a document outlining the terms of reference for a comprehensive review of the territory’s health and social services programs and services.

The six-page document, which Health and Social Services (HSS) Minister Pauline Frost tabled in the legislative assembly April 15, highlights five values, six “areas of focus” and two “foundational elements” that will guide the five-person independent panel spearheading the review.

It also contains a timeline of the review which shows that the panel’s deadline to provide the Yukon government with is final report, originally set for October, has now been extended five months to March 2020.

The panel’s chair, Bruce McLennan, told reporters during a technical briefing that the panel had requested an extension after seeing the “scope and nature of the review.”

“ … It became pretty clear that if we were going to do appropriate consultations or engagements with our stakeholders and partners, that we needed a timeframe to do a good and proper rock job,” he said via video call from Nanoose Bay, B.C. the afternoon of April 15.

The timeline, McLennan noted, requires the panel to share its draft recommendations with HSS by December 2019, meaning that Frost will have “a preliminary indications of where we’re going with the review and some preliminary recommendations so that she can plan as she goes into the future.“

According to the timeline, the review is broken down into five phases, the first of which has already been completed. It saw the formation of the independent review panel, as well as a group of cross-departmental Yukon government staff, known as the “tiger team,” collect and summarize existing data and reports to present to the panel.

HSS deputy minister Stephen Samis, who was also present at the technical briefing, said the team identified 14 “internal efficiencies,” some of which he said the department is already working on. Among them are identifying alternate payment systems for people on social assistance, he said — some jurisdictions, for example, no longer provide cheques, but the Yukon can’t deliver payment in anything but cheques due to the current regulatory system.

“They really are about kind of changing some of the ways in which we work, which is a little bit qualitatively different from … the next phase of the review, which is looking at the system as a whole,” he said.

Echoing Frost’s previous responses to questions from the Yukon Party and Yukon NDP this sitting, Samis said he wasn’t sure when the full list will be released, but that he suspected it “won’t be long” until they’re made public.

Other phases of the review, according to the timeline, will include more data-gathering and analysis of how things are done in other jurisdictions, various levels of “engagement” with “partners” and “stakeholders” — Yukon residents, Yukon First Nations, not-for-profit organizations and medical professionals, for example — and the production of a draft report.

Samis said a “What We Heard” document produced from the engagements, as well as the independent panel’s draft and final reports, will all be made public.

Throughout the process, the panel will be guided by five values (access, quality, sustainability, coordination of care, and reconciliation), the terms of reference say, and focus on six key themes: primary health care and delivery models; coordination of care within and out of territory; system structure to better meet the needs of individuals with multiple layers, or “complex,” needs; aging in place; pharmacare and pharmaceutical benefits; and social supports.

The two “foundational elements” that will be supported through the review are “data collection, analysis and performance measurement” and a “cultural safety and cultural humility framework.”

The review’s six key themes do not state specific issues that they might encompass. The role of non-governmental organizations in delivering health care, for example, is not a listed as a focus of the review, McLennan said, but the topic could fall under the issue of delivery models.

The Yukon Party took issue with the lack of specific topics in the terms of reference during question period at the legislative assembly April 16, with MLA Patti McLeod questioning Frost over the fact that the medical travel program was not explicitly named within the terms of reference.

That was despite, McLeod noted, promises from the Yukon government that it would review the program, and then that it would include the program in the comprehensive review.

Frost replied that medical travel will “most certainly” be part of the review.

Medical travel also appears that it would be encompassed by the second theme of the coordination of care within out outside of the territory.

Contact Jackie Hong at jackie.hong@yukon-news.com