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180123 Physician Recruitment MIN= Attendance: Mayor Stephen Molnar Councillor Penny Esseltine David Calder, CAO, Town of Tillsonburg Sandy Jansen, CEO, TDMH Frank Deutsch, TDMH Board of Directors Dr. Jamie Cluett Dr. Brian Holowachuk Dr. Gerry Rowland Lesley Ross, Recruitment Coordinator, TDMH Lana White, Executive Assistant/Deputy Clerk, Town of Tillsonburg Regrets: Chair Dave Beres, Dr. Howard Lamb 1. Call to Order The meeting was called to order at 12:06pm. Councillor Penny Esseltine chaired the meeting. 2. Adoption of Agenda Resolution Moved By: Dr. Cluett Seconded By: Sandy Jansen THAT the Agenda as prepared for the Physician Recruitment & Retention Committee meeting of January 23, 2018, be adopted, with the addition of: - request for payment of financial incentives, M.Johnson - update report, Oxford County Recruitment Task Force Carried 3. Disclosures of Pecuniary Interest and the General Nature Thereof Dr. Rowland declared a conflict of interest with respect to Agenda Item 5.1. The Corporation of the Town of Tillsonburg PHYSICIAN RECRUITMENT & RETENTION Tuesday, January 23, 2018 12:00 noon Council Chambers 200 Broadway, 2nd Floor, Tillsonburg, ON N4G 5A7 MINUTES Physician Recruitment & Retention Committee, Minutes – January 23, 2018 - 2 - 4. Adoption of Minutes of Previous Meetings – September 19, 2017 Resolution Moved By: Dr. Cluett Seconded By: F.Deutsch THAT the Minutes of the Physician Recruitment & Retention Committee Meeting of September 19, 2017 be approved. Carried 5. General Business & Reports 5.1. Report CAO-17-02 – Physician Recruitment Incentive – Request for Reimbursement i) Information from Tillsonburg Family Physicians (provided separately) ii) Tillsonburg Recruitment Agreement, with Dr. Heeney D.Calder noted a correction to the recommendation contained in Report CAO-17-02. The Physician Recruitment and Retention Committee supports reimbursement of $10,000 to the Tillsonburg Family Physicians to cover the costs to improve the physical plant to accommodate the new recruit. The report incorrectly read $10,509.77. Noted as well, the recommendation was based on the program in place, therefore does not include a recommendation to assist with the mortgage. Clarification was given regarding housing offered by the hospital. It is in-kind housing, valued up to $7500, which the hospital owns and offers, rather than paying out additional costs. The housing offer is over and above the hospital’s 50/50 partnership with the Town. The asset(housing) was in place prior to the current incentive program, and was previously used by the hospital as an incentive. Discussion was held with regard to the current incentive program/model, the issue of Dr. Heeney’s mortgage, and the prepared agreement. With respect to mortgage costs, the clinic was advised that a subsequent request could be submitted for further consideration. If this Committee wants to make an amendment to the current model, that would require Council’s approval. Physician Recruitment & Retention Committee, Minutes – January 23, 2018 - 3 - There was further discussion and a suggestion of 6 months of housing support, up to a specified value. This would result in adding another bullet point/incentive to the current program. The following resolution was passed. Resolution Moved By: Dr. Rowland Seconded By: S.Jansen THAT the matter of mortgage support/rent support, as a consideration for the physician recruitment incentive program, be referred to the Hospital CEO and the Town CAO for further review and recommendation. Carried Discussion was held regarding Report CAO-17-02 and the recommendations contained therein, as well as supporting documents and submitted expenses, the agreement, and expectations. The following resolution was passed. Resolution Moved By: Mayor Molnar Seconded By: S.Jansen THAT the Physician Recruitment and Retention Committee receives Report CAO-17-02, Physician Recruitment Incentive – Request for Reimbursement; AND THAT the Physician Recruitment and Retention Committee supports reimbursement of $36,000 for December 2017 to May 2018 to the new recruit for clinic overhead costs; AND THAT the Physician Recruitment and Retention Committee supports reimbursement of $510.20 to the new recruit for moving expenses; Physician Recruitment & Retention Committee, Minutes – January 23, 2018 - 4 - AND THAT the Physician Recruitment and Retention Committee supports reimbursement of $10,000.00 to the Tillsonburg Family Physicians to cover the costs to improve the physical plant to accommodate the new recruit; AND FURTHER THAT the attached Tillsonburg Recruitment Agreement form be signed by the CEO, CAO, the relevant medical clinic and the new recruit. Carried Dr. Cluett and Dr. Holowachuck abstained from voting. The Recruitment Coordinator to arrange for execution of the agreement. 6. Other Business 1. Request for payment of financial incentives, Matthew Johnson The request has been submitted and will come forward at the next meeting. 2. Update report, Oxford County Recruitment Task Force Dr. Rowland provided an update. He has received formal notification that they have been funded another year by the County. The Task Force is working to increase its profile, through advertising and website presence. It was noted that the County group does not provide incentives. When a candidate applies to the County group, it is circulated to the County-wide group. Physicians planning to retire within 3 years can contact Dr. Rowland, confidentially for the file. As new candidates apply, with the candidate’s permission, their information can be passed on to the physician considering retirement. ‘Oxford County Physician Recruitment Update’ to be included on future agendas. 7. Next Meeting The 2018 meeting schedule was discussed. The next meeting to be scheduled for February 20 @ 12noon. Physician Recruitment & Retention Committee, Minutes – January 23, 2018 - 5 - Meetings to be scheduled for the 3rd Tuesday of every month, as placeholders. If a meeting is not needed, it will be cancelled for the month. Item(s) for Next Meeting: - With all 3 practices essentially at capacity, a request to discuss the possibility of setting up a clinic in the hospital, as a physical plant for future recruits. S.Jansen to bring forward information about that at the next meeting. 8. Adjournment Resolution Moved By: Dr. Holowachuk Seconded By: Dr. Cluett THAT the Physician Recruitment & Retention Committee Meeting of January 23, 2018, be adjourned at 1:02 p.m. Carried = Attendance: Chair Deputy Mayor Dave Beres Mayor Stephen Molnar Councillor Penny Esseltine David Calder Frank Deutsch Dr. Gerry Rowland Dr. Brian Holowachuk Lesley Ross Lana White 1. Call to Order The meeting was called to order at 12:07pm. 2. Adoption of Agenda Resolution #1 Moved By: Dr. Rowland Seconded By: Councillor Esseltine THAT the Agenda as prepared for the Physician Recruitment & Retention Committee meeting of September 19, 2017, be adopted. Carried 3. Disclosures of Pecuniary Interest and the General Nature Thereof Dr. Rowland declared an interest with respect to Agenda Item 5.1. 4. Adoption of Minutes of Previous Meetings – May 16, 2017 Resolution #2 Moved By: Councillor Esseltine Seconded By: F.Deutsch The Corporation of the Town of Tillsonburg PHYSICIAN RECRUITMENT & RETENTION Tuesday, September 19, 2017 12:00 noon Council Chambers 200 Broadway, 2nd Floor, Tillsonburg, ON N4G 5A7 MINUTES Physician Recruitment & Retention Committee, Minutes – September 19, 2017 - 2 - THAT the Minutes of the Physician Recruitment & Retention Committee Meeting of May 16, 2017 be approved. Carried 5. General Business & Reports 5.1. Report CAO-17-01 – Physician Recruitment Incentive – Request for Funding D.Calder reviewed his report, CAO-17-01, noting that staff have made a recommendation based on the model. Dr. Rowland spoke regarding payment to the clinic, as that was recommended by the recruit’s accountant. D.Calder noted that the intent of the program was to reimburse the recruit not the clinic, adding that he would like to look at the tax implications. Discussion was held to adopt the recommendation in principle, with opportunity for the CAO to research tax implications. Resolution #2 Moved By: Councillor Esseltine Seconded By: F.Deutsch THAT the Physician Recruitment & Retention Committee approve Report CAO-17-01 as amended, providing opportunity for the CAO to research tax implications. Carried L.Ross to facilitate signing of the agreement. 5.2. Update – Dr. Rowland – Oxford County Physician Recruitment Dr. Rowland provided an update. The Oxford County group will be going back to the County in October with a request for 2018 funding. An increase in funding will be requested. The group is reaching out to all physicians in the County, asking those physicians that are planning to retire in the next 3 years to let the group know so that a ‘confidential’ list can be compiled. Dr. Rowland reported on the group’s advertising campaign. 9 physicians have been placed within Oxford County. Physician Recruitment & Retention Committee, Minutes – September 19, 2017 - 3 - 5.3. Survey Results – Physician Recruitment – Oxford County Budget Survey Chair Beres reported on the survey conducted by Oxford County. 5.4. SWLHIN Physician Orientation Pilot Project (3 attachments) L. Ross reported. There is a new pilot project being developed in Elgin and Oxford. They are looking for support. 6. Other Business 7. Next Meeting The next meeting to be at the call of the Chair. 8. Adjournment Resolution #3 Moved By: L.Scott Seconded By: F.Deutsch THAT the Physician Recruitment & Retention Committee Meeting of September 19, 2017, be adjourned at 1:05p.m. Report Title Physician Recruitment Incentive – Request for Reimbursement Report No. CAO – 17 - 02 Author David Calder, CAO Meeting Type Physician Recruitment and Retention Committee Committee Date November 28, 2017 Attachments  INFORMATION FROM TILLSONBURG FAMILY PHYSICIANS (DISTRIBUTED SEPARATELY)  TILLSONBURG RECRUITMENT AGREEMENT Page 1 / 3 RECOMMENDATION THAT the Physician Recruitment and Retention Committee receive report CAO 17-02 Physician Recruitment Incentive - Request for Reimbursement; AND THAT the Physician Recruitment and Retention Committee supports reimbursement of $36,000 for December, 2017 to May, 2018 to the new recruit for clinic overhead costs; AND THAT the Physician Recruitment and Retention Committee supports reimbursement of $510.20 to the new recruit for moving expenses; AND THAT the Physician Recruitment and Retention Committee supports reimbursement of $10,509.77 to the Tillsonburg Family Physicians to cover the costs to improve the physical plant to accommodate the new recruit; AND FURTHER THAT the attached Tillsonburg Recruitment Agreement form be signed by the CEO, CAO, the relevant medical clinic and the new recruit. EXECUTIVE SUMMARY Committee will recall that on December 13, 2016 it approved a Shared Physician Recruitment Incentive Support Model. The Committee subsequently reported to Tillsonburg Town Council in order to obtain Town Council support of the model. On April 24, 2017, Town Council approved the model and funding up to a maximum of $60,000 split 50/50 with Tillsonburg District Memorial Hospital for up to 2 physicians in 2017. In accordance with locally generated statistics, the current complement of family physicians does not meet the nee d of the Tillsonburg population. Tillsonburg and area has been identified and recognized as a high needs area as some local residents are experiencing difficulty in finding a family physician . Page 2 / 3 CAO BACKGROUND As Committee knows, physician recruitment is critical to meeting the primary health care needs of our growing population. Lack of access to family physicians is not only a serious community health issue, impacting our citizens, but also an economic development issue impacting the Town’s business community. Recognizing this need, the Town of Tillsonburg and Tillsonburg District Memorial Hospital (TDMH) and local physicians have worked together as part of the Physician Recruitment and Retention Committee to develop an incentive support model in order to assist in attracting physicians to the area. Subsequently, the Shared Physician Recruitment Incentive Support Model was approved a nd staff have received a second request to access the support model. In addition, the committee approved the following recommendation at its meeting of May 16, 2017: “THAT the two CAOs (CEO of TDMH) of the partnered agencies, assisted by the facilitator, act as the recommending arm for any and all correspondence that requests participation in the Tillsonburg Recruitment Program; AND FURTHER THAT the recommendation be circulated to members of the Committee for approval.” Direction was also provided that the member of the FHO requesting access to the funds would not vote on such item before the Committee for consideration. CONSULTATION/COMMUNICATION On December, 2017, the Town of Tillsonburg CAO, the CEO of Tillsonburg District Memorial Hospital and the Physician Recruitment Facilitator met to review the funding request from the Tillsonburg Family Physicians. RECOMMENDATION Based on a review of the request for funding, a review of the incentive program as approved and knowledge of the Hospital activities of Dr. Heeney, staff discussed the funding request as provided by Tillsonburg Family Physicians. The funding request includes office overhead expenses for six months, moving expenses and physician plant expenses with corresponding receipts. The material provided by Tillsonburg Family Physicians also includes costs of $5,097.72 associated with six months of mortgage costs for housing. This report is recommending approval of the funding in accordance with the program model and following Committee direction by providing funds directly to the FHO for physician plant improvements and monthly overhead costs directly to the recruit, who is then responsible to pay the clinic. Page 3 / 3 CAO In addition, this report recommends the payment of moving expenses as documented in the material from Tillsonburg Family Physicians. Staff is requesting the Committee’s direction related to the reimbursement of six months of mortgage payments as this report interprets the housing incentive from TDMH to be for the free use of a supplied apartment unit if required. Although there is a monetary value attributed to the apartment the question is whether the intent was to provide any kind of cash reimbursement for housing costs, such as mortgage payments, associated with the new recruit? COMMUNITY STRATEGIC PLAN IMPACT As noted in the Community Strategic Plan (CSP), the plan identifies the need to ensure senior’s health care and gaps in local services and to provide needed senior’s health care and support services. As new families move to the Tillsonburg community, the need for family physicians also continues. FINANCIAL IMPACT/FUNDING SOURCE The 2017 Town of Tillsonburg budget contains $60,000 in reserves for the funding of the Physician Recruitment Incentive Support Model. Tillsonburg District Memorial Hospital also has funding available for the Physician Recruitment Incentive Support Model. Any approved funding allocation would be split 50/50 between the Town of Tillsonburg and Tillsonburg District Memorial Hospital. If the current funding was approved by the Committee, each partner would fund $23,509.99. If the Committee approved 6 months of mortgage payments then the financial impact would increase. As previously noted there would be conditions placed on any recipients of the proposed incentives as outlined in Appendix “B” Tillsonburg Recruitment Agreement. Tillsonburg Recruitment Agreement Welcome to your new career in the Town of Tillsonburg (the Town) and Tillsonburg District Memorial Hospital (TDMH). This document confirms that you agree to:  Practice in Tillsonburg for a minimum of five years.  Provide a minimum of four (4) full days/week of professional, medical services in Tillsonburg.  Cover your share of a combination of hospital inpatient coverage, and/or ED coverage, and/or Anesthesia services In turn, the Town and TDMH will:  Continue $510.20 in moving expenses for relocation to Tillsonburg.  Provide up to $10,000 for Clinic space and equipment updates to Tillsonburg Family Physicians.  Provide $36,000 to you, for the first six months, for clinic overhead costs. We the undersigned concur with this Tillsonburg Recruitment Agreement. Sandy Jansen, President and CEO David Calder Tillsonburg District Memorial Hospital CAO, Town of Tillsonburg Physician Representative Dr. Rebecca Heeney Tillsonburg Family Physicians