Additions 2009/11/30
ADDITIONS TO COUNCIL, MONDAY NOVEMBER 30 2009
PLEASE BE IN THE UPSTAIRS LOBBY AT 4:45 FOR A PICTURE TO PROMOTE THE OLYMPIC
TORCH RUN.
IN CAMERA
1. Additional Resolution to go In Camera.
COUNCIL
1. Copy of Presentation from Dr. Myron Haluk.
2. RE: PD-2009-96 -Designation of the Earl A. Thomas House, 6320 Pine Grove
Avenue
a) Letter from Re Charge dated November 27, 2009.
3. Email from Toni Williams, General Management Downtown Niagara Falls BIA
re: Request for Deferral of report and presentation
From: Cathy Crabbe
To: Dean Iorfida
Date: 11/27/2009 4:05 PM
Subject: Re: Picture
Dean:
Because we are an Olympic Torch Relay and Celebration Community, Dale Morton would like to have a picture of our City Council,
wearing Olympic red mittens....to be supplied by Dale. The picture will be pasted on the City's homepage. This is just another way
to promote the Torch Run and Celebration In Niagara Falls.
Dale will meet the Councillors in the upstairs lobby at 4:45 p.m. to take this picture.
Because you indicated to Ted that you were not expecting to retum to the office this afternoon, he did not make plans to return to
the office after his early afternoon appointments. I should, however, see if he wants to get together with you on Monday. I'll let
you know.
Thanks
Cathy
-cn.nr.n .._ .
The City of Niagara Falls, Ontario
Resolution
November 30, 2009
No.
Moved by
Seconded by
WHEREAS s. 239(7) of the Municipal Act, 2001 (hereinafterreferred to asthe "Act") mandates that
the municipality or local board or a committee of either of them shall record without note or
comment all resolutions, decisions, and other proceedings at a meeting of the body whether it is
closed to the public or not; and
WHEREAS s. 239(8) of the Act requires that the record required by subsection 239(7) shall be
made by the Clerk of the Corporation in the case of a meeting of council; and
WHEREAS on November 30, 2009, Niagara Falls City Council will be holding a Closed Meeting
as pernutted under s. 239(2)(d) of the Act; and
WHEREAS one of the items on the Closed Meeting agenda pertains to labour relations matters
(s.239 (2)(d)); and
WHEREAS due to the nature of the discussion in the Closed Meeting, it is not appropriate for City
staffto be in attendance, save the Chief Administrativeofficer and the Director of Human Resources
("HR"); and
WHEREAS s. 228(4) permits the Clerk the discretionary authority to delegate in writing to any
person, other than a member of council, any of the clerks powers and duties under the Act.
THEREFORE BE IT RESOLVED THAT on November 30, 2009, the Clerk, Dean Iorfida,
delegates his authority for the purposed of the Closed Meeting to the Director of HR, Trent Dark;
and
FURTHER BE IT RESOLVED THAT the Director of HR will record without note or comment
all recommendations to Council emanating from the Closed Meeting; and
FURTHER BE IT RESOLVED THAT the Clerk will resume his duties upon conclusion of the
item on the Closed Meeting agenda that falls under labour relations.
AND The Seal of the Corporation be hereto affixed.
DEAN IORFIDA R. T. (TED) SALCI
CITY CLERK MAYOR
GNGH Emergency Department
Review for City Council
November 30 2009
OMA Section on Emergency Medicine
Emergency Physicians of Ontario
GNGH ED Physician Staffing Levels
^ "While there is no consensus as to the "ideal"
workload in the American literature, in a
hospital with afast-track, and limited
requirements for bedside teaching, estimates are,
on average, a physician should see 4.3 patients
per hour" (Hay Gxoup)
^ Murray, St. Paul's and POWER 1 reviews,
averaged 2.5 to 3.0 patients per hour
z ~
GNGH ED Physician Staffing Levels
POWErZ2 POWEIZ2 HAY POWER2 GNGH
Paediatric Adult AFA Group 3 FFS Model FFS Model
AFP Model Review
Model Range
2.2 2.9 2.5-3.0 4.4 4.75
3
GNGH ED Physician Staffing Levels
^ Thus, Emergency Physician productivity at
the GNGH Emergency Department prior to
September 15th, 2009 was essentially
consistent with productivity levels directly
observed and measured in a recent, large,
multi-centre prospective Ontario study
involving peer group Fee for Service
Emergency Departments.
4
Ontario ED Physician Payment Models
^ There are NO ministry Staffing Guidelines
^ Departments are sometimes not able to fully
staff
^ There are multiple payment models in Ontario
^ Emergency Department Funding models are
NOT best practise staffing models
^ GNGH ED Physicians are paid FFS as
authorized by the Health Insurance Act
5
The NHS and ED Physician
Payment Models
^ In February of 2008, one year before the Hay
Group report, the NHS Board noted that "sve
have moved our 3 Southern Tier .rites into an ED AFA
arrangement and are noav beginning albrocess to
reconfigure our Northern Tier ,rites"
6
GNGH ED Physician Shifts
^ 12 hoax shift length averages with 10 day, auto
generating schedule
^ No burn out or absenteeism reported
^ Scheduling was fair, accepted, and sustainable
^ GNGH ED physicians recruited 2 new ED
Physicians to support department to cover fox
one physician's leave of absence
^ Physicians agreed to further recruitment with
input
GNGH ED Wait Times
^ "The majority of emergency department waiting
fox urgent and emergent patients is a result of
waiting for an available inpatient bed" (2006
Ontario Study)
^ "The primary cause of ED overcrowding is
hospital overcrowding"(CAEP position)
^ The GNGH ED had the shortest ED wait times
and lowest left without being seen patients in
the NHS Region
8
GNGH ED Wait Times
^ All departments in the province are
overburdened with admitted patients
warehoused in the ED
^ Total Department length of stay is measured
from first encounter until a patient j~hyrically leaver
the Emergency Department
^ Emergency Physician response times are NOT
measured at the GNGH and not measured
provincially
9
GNGH ED Complaint Levels
^ The NHS administration referenced an
"increasing number of patient complaints about
wait times and treatment at the GNGH ER"
(Sept 30th to Mayor Salci)
^ The Hay Group did NOT review complaints
^ The NHS did not substantiate its assertions,
except to graph absolute numbers of reported
complaints at the GNGH vs other NHS sites
,o
Current ED Physician Coverage
^ 1/3Yd by existing GNGH staff
^ 1 /3Yd by cross covering NHS staff
^ 1/3Yd by HealthForce Ontario staff
^ Top ups to Emergency Physicians a significant
NHS and public expense and not sustainable
^ Have Wait Times Increased?
Fiduciary Duties in Health Care
^ Physicians have the greatest fiduciary
responsibility to their patients
^ Therefore, physicians should not be restricted in
their ability to speak out publicly in the interests
of their patients
72
The Hay Group and Standards of Care
^ Neither the Hay Group nor the NHS is
authorized to establish standards of care in
emergency medicine
^ Hay group report lacked objectivity and
transparency
^ Details expected in an expert report are lacking
^ See page 11-12 of Section review
13
Summary
^ The GNGH Emergency Physicians were
providing full service emergency care to the
Niagara Falls community for decades
^ The GNGH Emergency Physicians were very
productive and provided unique skills and
dedication to the department
^ The NHS assumption of scheduling control of a
stable fully staffed Emergency Department is
unprecedented
74
Community Service Recognition
^ The six GNGH Emergency Physicians
combined have provided over 50 years of
dedicated full time service to Niagara Falls
^ They should be recognized for their
distinguished contributions to the community
15
Public Hospitals Act
^ Broad based loss of confidence in the NHS administration
^ Solution: Ciry Council should request that provincial cabinet
appoint an investigator. Not full judicial investigation but a
focused inquiry.
^ "Section 8. X11 The Lieutenant Governor in Council may
appoint one or more persons to investigate and report on the
quahty of the management and administration of a hospital, the
quality of the care and treatment of patients in a hospital or any
other matter relating to a hospital where the Lieutenant
Governor in Council considers it in the public interest to do so.
^ Need for independent investigator (e.g., refixed judge) appointed
with input of Ctry Council
^ Direction to investigator to hear submissions from members of
public
1s
Questions
^ Thank you
^ Questions?
RE~CHARG
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November 27, 2009
His Worship Mayor Ted Salci
And Members of the Municipal Council
City of Niagara Falls, Ontario
Re: PD-2009-96
Designation of the Earl A. Thomas House
6320 Pine Grove Ave, Niagara Falls
Further to our recent letter dated November 9, 2009, together with drawings, please be
advised that we do not believe [he Recommendation to Council considers one important point:
the Reasons for Designation statement clearly indicates that "this is the largest property in the
immediate area occupied by a single detached dwelling". This property consisted originally of
S lots on a registered plan; it is now 4 lots. The report suggests that there are several other
single family properties consisting of 2 or 3 lots. These however are not identified. As
Council and Staff are aware a lot on a registered plan maybe transferred to any owner without
consent. The house at 6320 Pine Grove sits equally on Lots 133 and Lot 134. The size of
these two lots together is of a size equaling any on the street. The streetscape and set -back
would be consistent with thoseon the street. Examination of the drawing attached cleazly
shows [hat there are no significant trees on Lot 132. The best trees are located on the lot line
between Lot 134 and Lot 135. Lot 135 could be built on with the loss of only one significant
tree.
As Council and Staff are aware, the proposed Designation By-Law includes alt four lots; it
need cover only two. If it is passed as presented, then one could be left in the position of
having Lots 132 and Lots 135 sold with a Historical designation attached to them. They
would [hen be owned by different individuals. What would the meaning of the designation on
these vacant lots mean? Could a new owner apply for a building pemtit for a new home with
a design which is sympathetic to a Heritage designation?
The ambiguity and uncertainty surrounding such a broad designation is not good planning.
Please consider these comments in making a determination. Thank you.
Yours_ truly,
Rob/e~rt, J/Wil'kins
President c% William J. Walker Gowlings
1 /30/2009 Dean to ida -Presentation Toni ht Pa e 1
From: <toni@bluenewtnorth.com>
To: "'Dean lorfida"' <dio~da@niagarafalls.ca>, <ktodd@niagarafalls.ca>
Date: 11/30/2009 11:41 AM
Subject: Presentation Tonight
Dean,
Regarding the presentation at today's Council Meeting.
The BIA is currently looking into the feasibility of the CIP Grant
participation, at this point we have not yet compiled all the data necessary
to present at this time. Therefore we request to bring this forward at a
later date; which is yet to be determined. However; we would like to
request that the next Steering committee meeting be set up as soon as
possible as we have many issues that need to be addressed, CIP's being one
of them.
I apologize in advance for any inconvenience this may have caused you
Thank you,
Toni Williams
General Manager, Downtown Niagara Falls BIA
4691 Ontario Avenue, Niagara Falls, ON L2E 3R1
P: 905 356-5444
www. queenstreetniagarafalls.com
http:!/twitter. com/downtownniagara
Director of Marketing
Historic Niagara Developments, Inc.
4681 Ontario Ave. Niagara Falls, ON L2E 3R1