McCaig lays out clinic timeline

As the process to have a non-profit corporation run the Fort Frances Clinic and establish a Family Health Team (FHT) here moves forward, Fort Frances CAO Mark McCaig made it clear Monday night how everything has come together to reach this point.
“It has been a highly-talked about issue in the community and I appreciate that very much,” McCaig said at Monday night’s council meeting, prior to outlining an entire chronology of clinic-related events leading up to the present.
“People care about health care services, it’s something near and dear to their hearts,” he added.
“I’m not going to sit here and tell you everyone at this table are experts,” McCaig stressed. “We’re breaking new ground here as it relates to health care. Everybody knows that.
“So if there’s been missteps or mistakes, I think it’s to be expected.
“But where we’re going right now, and where we’re at, I’m fairly comfortable it’s truly becoming a community-based initiative which the government of this province is leading municipalities into at this point,” noted McCaig.
He said the town first was approached by local physicians last spring about instituting different methods of delivering health care here (particularly a FHT).
But prior to that, the local physician recruitment and retention committee (which included McCaig, Mayor Dan Onichuk, and Coun. Todd Hamilton) already was well-aware that doctors were leaving town—and far less likely to come here—because the clinic model didn’t work any more.
It was hammered home at multiple meetings of that committee that physicians no longer were interested in “running a business” and wanted instead to focus on seeing patients.
In an effort to solve the problem with the clinic operating model, the committee looked at several options.
Jim Neufeld of Winkler, Man. was brought in to describe how his community revamped the way its clinic worked to much success.
Meanwhile, another option—calling on independent consultant Colson and Associates to develop a FHT proposal—was explored but not pursued due to cost and unwillingness to be involved in the implementation of a FHT.
A final option, put forward by local physicians last March, was a third-party agreement with the Sault Ste. Marie and District Group Health Association (GHA).
This concept involved the sale of the building and assets, and the development of an FHT.
The Fort Frances Clinic Partnership felt the GHA option was the quickest, most effective implementation of a FHT, which also addressed the issue of a physician-owned building by transferring the ownership to a not-for-profit organization.
Here is how things unfolded from there:
•On May 2, 2005, Dave Murray of the GHA met in-camera with council to request support from the town through a serious expression of interest.
•On May 9, 2005, council approved proceeding with the matter of a preliminary proposal regarding the clinic.
•On June 13, 2005, there was an in-camera session with Murray to discuss developing an Memorandum of Understanding (MoU) with the GHA. A draft was received on June 27.
•Between June 27 and Aug. 22, 2005, council and administration consulted with doctors, the GHA, and the town solicitor regarding the MoU, at which time it was identified that the mayor and council viewed themselves as a financier and not intimately involved with the day-to-day operations of the clinic.
It also was determined this would be an interest-free loan, amortized over 15 years, to purchase the outstanding shares of the clinic and provide the new non-profit corporation with some start-up funds.
•On Sept. 26, 2005, council received letters from the doctors stressing the urgency of proceeding with a model change. Council passed a resolution to hold a public forum to present the details of the initiative and seek public input.
•This meeting was held Oct. 12, 2005, at which time GHA representative Greg Punch presented the concept of a new non-profit organization that would be used to purchase shares of the clinic.
At this stage, he also stated that GHA would not be the “owner” of this corporation.
McCaig stressed that contrary to some talk in the community, there was never any agreements made prior to this meeting other than the MoU (which since has become a “moot point” given the fact GHA’s role has changed from active member to advisor).
Furthermore, discussions to this point had been in-camera primarily due to the fact they concerned “people’s personal finances” (i.e., shares of the clinic).
•On Oct. 24, 2005, council passed a resolution authorizing administration to develop an agreement with GHA in the form of a loan contract to provide up to $1 million at zero percent interest for a period of 15 years, contingent on GHA meeting the conditions of a financing agreement put forward by the town.
•Following a GHA board meeting on Nov. 28, 2005, the town was notified by Punch that the GHA would not be an active board member of the new non-profit organization, but instead would participate as an advisor.
The rationale for this was the GHA was a consultant and receiving financial benefit.
GHA also asked the town to amend its resolution to provide financing to a new non-profit organization and GHA. Council passed this resolution on Dec. 12, 2005.
•On Jan. 9, 2006, McCaig advised council that the incorporation of a new corporation had been started, and for that purpose an inaugural board had to be formed.
This board came to include town representatives Mayor Onichuk and Coun. Hamilton, Riverside Health Care Facilities Inc. CEO Wayne Woods, Fort Frances Clinic president Dr. Robert Algie, and community rep John McTaggart.
McCaig and Fort Frances Clinic administrator Maureen Gartshore are acting in advisory roles, with the GHA providing overall guidance.
•Articles of incorporation were signed on Jan. 26 and filed under the title of Fort Frances Community Clinic Inc.
•Last week, the board forwarded an application to become a FHT to the GHA, which, in turn, submitted the final application to the Ministry of Health and Long-term Care prior to the deadline for submissions today (Feb. 15).
This inaugural board also will begin the process of expanding the corporate bylaws, as well as determining the composition of the final board that will be established.
McCaig said the inaugural board eventually will be replaced by a “mixed-provider community-based board,” which “will be reflective of the community as a whole, with members from the general public, health care providers, and other significant stakeholders.”
The inaugural board also has to come up with a financial agreement with the Town of Fort Frances for shares of the clinic. In conjunction with this, the town is undertaking a full asset appraisal and a business valuation of the clinic.
Coun. John Albanese thanked McCaig for his presentation, noting he’d always felt council should let the public know details of what’s been going on with the clinic.