Tier 3 Provincial Working Group

Terms of Reference

• Purpose
• Functions of Provincial Working Group
• Term
• Membership
• Designating Alternates
• Roles and Responsibilities
• External Guests
• Communication
• Decision-Making
• Travel Expenses
• Terminology

Purpose

• The purpose of this Terms of Reference document is to establish the mode of operation for a Provincial Working Group that will help ensure a consistent approach¹ is taken across the province to the process of Tier 3 transfer of ”non-bedded” programs and services from affected hospitals to community agencies.
¹”consistent approach” is clarified to mean – development of common principles that can be applied provincially to set the foundation for further discussions at regional and local levels.

• The Tier 3 Provincial Working Group has been convened by the Ministry of Health and Long-Term Care (MOHLTC) to :
• develop principles that will guide the process of Tier 3 transfer;
• provide advice on issues of implementation; and
• construct a working definition of “non-bedded programs and services” that is specific to the Tier 3 process.

• Membership on the Tier 3 Provincial Working Group will be limited to a term of approximately four months during which members will assemble for one full-day faceto- face meeting per month and arrange interim meetings by teleconference, as needed.

• The Deputy Minister of Health and Long-Term Care set the parameters for membership of this ministry-led working group to include four representatives from divested hospitals, four representatives from community mental health agencies and one regional representative from the MOHLTC.
• Members of the Provincial Working Group have been chosen for their expertise in the field of mental health service delivery, their interest and/or professional involvement in program delivery and service divestment.
• Members of the Provincial Working Group will strive to attend meetings personally or by telephone if necessary to maintain continuity and consistency in discussion and group composition.

• Alternates will be considered at the discretion of the group Chair.
• If a substitute is absolutely required to attend on a group member’s behalf, then it is that Provincial Working Group member’s responsibility to contact the Chair and discuss the appropriateness of an alternate.
• Alternates must remain the same and be fully briefed by the group member in order to participate fully at Provincial Working Group meetings.

Roles and Responsibilities

• The Provincial Working Group will work collaboratively to develop principles and provide its best advice to the MOHLTC on issues pertaining to the transfer of nonbedded mental health programs and services from affected hospitals to community agencies.

• Ministry staff will be responsible for :
• Chairing and facilitating the meetings;
• Contributing comments and advice from a regional perspective; and
• Providing secretarial and administrative support to group members.
• The group as a whole will be responsible for respecting the confidentiality of all sensitive information, documents and discussions that are shared in meetings.

• The Tier 3 Provincial Working Group may seek additional input and expertise from guests such as clinicians and other service providers, or representatives from provincial groups, to answer specific questions or shed light on a particular issue.
• When external input is requested or required, the Tier 3 Provincial Working Group will agree upon :
• who will be invited;
• what questions will be asked of external invitees; and
• the process(es) that will be followed.

Communication

• Formal, written communication from and about the Tier 3 Provincial Working Group will come from the group Chair.
• Minutes and any action items arising from the meetings will be captured by the Secretary and distributed to members of the working group.
• Group will have a standing agenda item at the end of each meeting to discuss what information arising from their discussions is immediately shareable.

Decision-Making

• The Tier 3 Provincial Working Group will strive for consensus² around issues that require decision-making and, in the interest of time and remaining on task, may defer items that require further discussion to a later time.
• For issues where consensus cannot be reached, the minutes of the Tier 3 Provincial Working Group may, if requested, identify opposed members and the reasons why issues were not agreed upon.
² For the purpose of this Provincial Working Group, ’consensus” is defined as ”something the entire group can live with”.

Travel Expenses

• The MOHLTC agrees to remunerate the cost of Tier 3 Provincial Working Group members’ travel expenses to meetings, as well as provide access to teleconference numbers for interim meetings, as needed. Working group members will be provided instructions with respect to submitting their travel and accommodation receipts for reimbursement to appropriate ministry staff.

Terminology³

Tier 1 Divestment : The process of transfer of governance and operations of a Provincial Psychiatric Hospital (PPH) to a Public Hospital Board

Tier 2 Divestment : The subsequent process of transfer of psychiatric beds and associated services received by a Tier 1 receiving Public Hospital Board (from a Provincial Psychiatric Hospital) to another public hospital as directed by the Health Services Restructuring Commission.

Tier 3 Divestment : The process of transfer of former PPH programs and services to a community agency (otherwise known as community reinvestment).

Note that Tiers 2 and 3 are mutually exclusive and not necessarily sequential processes. Tier 2 divestment is not a mandatory requirement or a prerequisite to the process of Tier 3 transfer of non-bedded programs and services.⁴

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