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13 - June 26, 2018 County Council Agenda Pkg./l/V I �cy " aM ORDERS OF THE DAY FOR TUESDAY, JUNE 26, 2018 — 9:00 A.M. ORDER 1st Meeting Called to Order 2nd Adoption of Minutes — June 12, 2018 3rd Disclosure of Pecuniary Interest and the General Nature Thereof 4th Presenting Petitions, Presentations and Delegations DELEGATIONS: None 5th Motion to Move Into "Committee Of The Whole Council" 6th Reports of Council, Outside Boards and Staff 7th Council Correspondence 1) Items for Consideration (none) 2) Items for Information (Consent Agenda) 8th OTHER BUSINESS 1) Statements/Inquiries by Members 2) Notice of Motion 3) Matters of Urgency 9th Closed Meeting Items — (see separate agenda) 10th Motion to Rise and Report 11 th Recess 12th Motion to Adopt Recommendations from the Committee Of The Whole 13th Consideration of By -Laws 14th ADJOURNMENT HERITAGE CENTRE GRAND OPENING - 12pm LUNCH WILL BE PROVIDED - 12:30pm NOTICE: July 10 and 24, 2018 County Council Meeting August 14, 2018 County Council Meeting AMO Annual Conference August 19 — 22, 2018 Ottawa November 23, 2018 Warden's Dinner — Masonic Centre of Elgin Accessible formats available upon request. 1 DRAFT COUNTY COUNCIL MINUTES Tuesday, June 12, 2018 Accessible formats available upon request. The Elgin County Council met this day at the Administration Building at 9:00 a.m. with all members present. Warden Marr in the Chair. ADOPTION OF MINUTES Moved by Councillor Mennill Seconded by Councillor Wiehle THAT the minutes of the meetings held on May 22, 2018 and June 4, 2018 be adopted. - Carried. DISCLOSURE OF PECUNIARY INTEREST AND THE GENERAL NATURE THEREOF — Councillor McWilliam declared a conflict of interest with regard to an item on the Closed Meeting Agenda relating to a Lease. At the appropriate time, Councillor McWilliam vacated the Council Chambers and refrained from discussing the item. DELEGATIONS Founder's Day Civic Service The Rev. Canon Nick Wells, Chaplin, Old St. Thomas Anglican Church with an invitation for the annual "Founders Day" Civic Service at the Old St. Thomas Church. Moved by Councillor Ens Seconded by Councillor Jones THAT the invitation from The Rev. Canon Nick Wells, Chaplain, Old St. Thomas Anglican Church be received and filed. - Carried. Ontario Works 2017 Year in Review and Children's Services 2017 Year in Review Kim Verkuil, Ontario Works Program Manager with a report providing a current synopsis of the Ontario Works division and an update on Social Assistance Modernization and Irma Pedersen, Supervisor of Children's Services with report titled "Children's Services 2017 Year in Review" providing a review of the organization's programs and objectives for the 2018 year. Moved by Councillor Martyn Seconded by Councillor Jenkins THAT the reports titled "Ontario Works 2017 Year in Review" and "Children's Services 2017 Year in Review" from Ontario Works and Children's Services, be received and filed. - Carried. �yh91�1 Geoff Hogan, Chief Executive Officer, SWIFT (SouthWestern Integrated Fibre Technology) and Adriana Dekker, Stakeholder Relations Manager with a PowerPoint presentation providing an overview of the SWIFT project, the current status of the project and information regarding membership in SWIFT. County Council Moved by Councillor Wiehle Seconded by Councillor Jones June 12, 2018 THAT the PowerPoint presentation titled "SWIFT" from the SWIFT Chief Executive Officer and the Stakeholder Relations Manager, be received and filed. - Carried. Assessment Base Management Part 2: Implementing ABM in Your Community Amanda Macdougall, Regional Manager, Municipal and Stakeholder Relations, MPAC with a PowerPoint titled "Assessment Base Management Part 2: Implementing ABM in Your Community". This presentation provided Council with suggestions on how to implement an assessment base management program in the municipality. Moved by Councillor Mennill Seconded by Councillor Wiehle THAT the PowerPoint presentation titled "Assessment Base Management Part 2: Implementing ABM in Your Community" from MPAC, be received and filed. - Carried. VON Middlesex -Elgin Michelle McKay, Manager, Fund Development VON Middlesex -Elgin and Shirley Biro, VON Volunteer with a PowerPoint presentation updating Council on the activities and programs of the VON and inviting them to participate in the organization's annual fundraiser the Great Community Run, Walk'n' Roll. Moved by Councillor Ens Seconded by Councillor Jenkins THAT the PowerPoint presentation titled "VON Middlesex -Elgin" from the Manager of Fund Development VON, be received and filed. - Carried. Council recessed at 10:29 a.m. and reconvened at 10:46 a.m. Moved by Councillor Mennill Seconded by Councillor Martyn THAT we do now move into Committee of the Whole Council. - Carried. SWIFT Membership — General Manager of Economic Development The general manager presented the report providing detailed information about SWIFT membership and recommending that Council authorize staff to negotiate SWIFT membership fees. Moved by Councillor Jones Seconded by Councillor Mennill THAT staff negotiate SWIFT membership fees with an upset limit of $3,400.00, as described in the report titled "SWIFT Membership" from the General Manager of Economic Development, dated May 31, 2018. - Carried. County Council June 12, 2018 Elgin County Official Plan Five (5) Year Review — Natural Heritage Study — Manager of Planning The manager presented the report reminding Council that the County of Elgin Official Plan is approaching its five-year review at which time the County agreed to consider the establishment of a Natural Heritage System Study. The manager sought Council's approval to enter into a service provider agreement with the Upper Thames River Conservation Authority to complete this study. Moved by Councillor Martyn Seconded by Councillor Jenkins THAT the Council of the Corporation of the County of Elgin authorizes the Warden and the Chief Administrative Officer to sign a "Service Provider" agreement with the Upper Thames River Conservation Authority to provide the work necessary to complete an Elgin Natural Heritage System Study. - Carried. Terrace Lodge Redevelopment Update (deferred from May 22, 2018 Council) — Chief Administrative Officer The Chief Administrative Officer presented the report providing background on the Terrace Lodge Rebuild project including information regarding servicing issues, Ministry approvals and spacing constraints. The report also provided a timeline surrounding a Request for Proposal (RFP) to hire external expertise consisting of an Architect, Engineer and Operations Consultant to complete a comprehensive study/business case for the rebuild or redevelopment of Terrace Lodge. Moved by Councillor Mennill Seconded by Councillor Martyn THAT staff provide a report with the results and costs of the RFP process to County Council at the July 10th meeting; and, THAT the report titled "Terrace Lodge Redevelopment Update" from the Chief Administrative Officer and Director of Financial Services, dated May 16, 2018, be received and filed. - Carried. Municipal Election 2018 Delegation of Powers during "Lame Duck" Council — Chief Administrative Officer The Chief Administrative Officer presented the report summarizing changes to the "Lame Duck Provision" under Bill 181 and seeking Council's approval to draft a by-law delegating certain authorities to the Chief Administrative Officer during the "Lame Duck" period. Moved by Councillor McWilliam Seconded by Councillor Mennill THAT the report titled Municipal Election 2018, Delegation of Powers during "Lame Duck" Council as prepared by the Chief Administrative Officer be received and filed; and, THAT the Chief Administrative Officer be directed to prepare the necessary by-law prior to Nomination Day (July 27, 2018) delegating authority to the Chief Administrative Officer from July 27, 2018 to December 13, 2018 to: a) Be the financial signing authority for expenditures, outside the current budget, exceeding $50,000 and/or for the disposition of any real or personal property of the municipality which has a value exceeding $50,000 at the time of disposal; and, b) That the by-law shall come into force and effect only in the event that less than 75% of the current Members of Council will be returning to sit on the new Council after Nomination Day of the 2018 Municipal Elections, as determined by the CAO/Clerk. - Carried. County Council CORRESPONDENCE Items for Information (Consent Agenda) June 12, 2018 1. Invitation to World Elder Abuse Awareness Day at John Kenneth Galbraith Reference Library — Dutton on Friday, June 15, 2018 at 1:00 p.m. 2. Invitation to Grand Opening of the New Elgin County Heritage Centre on Tuesday, June 26, 2018 at 12:00 p.m. Moved by Councillor Jones Seconded by Councillor Jenkins THAT Correspondence Items #1 & 2 be received and filed - Carried. Closed Meeting Items Moved by Councillor Wiehle Seconded by Councillor Mennill THAT we do now proceed into closed meeting session in accordance with the Municipal Act to discuss matters under Municipal Act Section 239.2; (a) the security of the property of the municipality or local boards — Lease (e) litigation or potential litigation, including matters before administrative tribunals, affecting the municipality or local board: (f) advice that is subject to solicitor -client privilege, including communications necessary for that purpose; (k) a position, plan, procedure, criteria or instruction to be applied to any negotiations carried on or to be carried on by or on behalf of the municipality or local board. 2001, c. 25, s. 239 (2); 2017, c. 10, Sched. 1, s. 26. - Carried. Councillor McWilliam vacated the Council Chambers at 11:19 a.m. and returned to the Chambers at 11:25 a.m. after the item related to a Lease had been discussed. Moved by Councillor Martyn Seconded by Councillor Jenkins THAT we do now rise and report. - Carried. Moved by Councillor Mennill Seconded by Councillor Jones THAT the Warden and Chief Administrative Officer be authorized and directed to sign a lease agreement with 1342961 Ontario Inc. for Suite 313 and Storage Room 34; and, THAT the lease commence on May 1, 2018 for a lease rate of $17.14 per square foot ($40,450.00 annual payment), plus the HST for year one, and $17.48 per square foot ($41,253.00 annual payment), plus the HST for year two; and that the lease rate for Room 34 be leased at $7.65 per square foot ($765.00 annual payment) plus the HST for both years. - Carried. Moved by Councillor Mennill Seconded by Councillor Jenkins THAT the confidential report from Chief Administrative Officer be received and filed. - Carried. County Council 5 June 12, 2018 REPORTS (continued) Port Bruce Bridge Update — Director of Engineering Services The director presented the report providing Council with an update on the Port Bruce Bridge and temporary bridge. This update included information about the public information session held on June 11, about the contractor selected for installation and about enhanced detour signage in place. Moved by Councillor Martyn Seconded by Councillor Mennill THAT the report titled "Port Bruce Bridge Update" from the Director of Engineering Services, dated June 7, 2018, be received and filed. - Carried. Contract Award — Port Bruce Temporary Panel Bridge Installation Contract No. 6290-18-05 — Director of Engineering Services The director presented the report recommending that McLean Taylor Construction be selected for the Port Bruce Temporary Panel Bridge Installation. Moved by Councillor Mennill Seconded by Councillor Jenkins THAT McLean Taylor Construction be selected for the Port Bruce Temporary Panel Bridge Installation Tender, Contract No. 6290-18-05 at a total price of $972,000.00, inclusive of a contingency allowance and exclusive of H.S.T.; and, THAT the Warden and Chief Administrative Officer be authorized to sign the contracts - Carried. OTHER BUSINESS Statements/Inquiries by Members — None. Notice of Motion — None. Matters of Urgency — Road Assumption in the Township of Malahide The Chief Administrative Officer presented the report recommending that Council approve the temporary assumption of several Malahide Township Roads in order to be able to complete work associated with the installation of the temporary bridge. Moved by Councillor Mennill Seconded by Councillor Jenkins THAT Elgin County Council approve the temporary assumption of Bank Street (north of Catfish Creek), Rush Creek Line and Lewis Street Road Allowances and subject to further negotiation, the long-term assumption of Dexter Line (Bank Street south of Catfish Creek) and extending southerly to Colin Street from the Township of Malahide; and, THAT Elgin County Council authorize staff to enter into an agreement with the Township of Malahide including the following terms and conditions: 1. Malahide agrees to provide Elgin with photocopies of all relevant plans, construction specifications, and maintenance records for road allowances to be assumed, and furthermore, Malahide shall cooperate with Elgin Engineering Services in answering inquiries as to current conditions of such road allowances. County Council June 12, 2018 2. Save and except for claims attributable to negligence on the part of Elgin or its contractors, Malahide shall release Elgin from any and all claims relating to the assumption of the road allowances and specifically including claims and/or complaints relating to works upon or improvement by Elgin or its contractors. 3. Malahide shall indemnify Elgin and/or its contractors from claims relating to existing conditions upon road allowances to be assumed, including in respect of encroachments thereon and to be removed therefrom but excluding claims related wholly to installation of the temporary bridge and associated mitigation measures. 4. Malahide shall not charge Elgin for the maintenance of the road/road allowances to be assumed save and except for the extension of Bank Street south of Catfish Creek (which road has been presumed and continues to be presumed and will be treated as a County road for purposes of road maintenance). 5. By resolution, Malahide shall assent to assumption of the road allowances by Elgin through a by-law adding road allowances to the County System. Malahide does not intend to oppose or challenge a subsequent repeal of assumption by-law by Elgin provided that a new Imperial Road Bridge is open and Elgin traffic is restored to Imperial Road; the temporary bridge is removed and the area restored; and the road allowances are in at least the equivalent condition to their current status. 6. Malahide shall otherwise cooperate fully with Elgin in respect of the installation of the temporary bridge and associated mitigation measures including but not limited to approval of local improvements to be completed by the County and enactment of traffic and parking regulations upon Malahide roads not assumed as required to implement the traffic plan prepared and implemented by Elgin. 7. Malahide, as contractor to Elgin, shall conduct patrols, in accordance with the Minimum Maintenance Standard requirements of a Class 2 road and the County Road Maintenance Agreement, of the roads to be assumed and the municipal roads not assumed but within the area of traffic control to ensure that required traffic control measures, including but not limited to signs, barrels, and temporary signals are in place and operational; provided that Malahide, as contractor to Elgin, shall reinstate such traffic control measures or otherwise advise Elgin Engineering Services of need to do so when Malahide forces are unqualified, unequipped, or unavailable to do so; and provided further that, in addition to such patrols, Malahide shall use its best efforts to secure the assistance of its employees travelling within the area of traffic control to report to, firstly, Malahide and, secondly and alternatively, Elgin any observed operational difficulties with traffic control measures. - Defeated. Moved by Councillor Mennill Seconded by Councillor Jenkins THAT County Council approve the temporary assumption of Bank Street (north of Catfish Creek), Rush Creek Line and Lewis Street Road Allowances and subject to further negotiation, the long- term assumption of Dexter Line (Bank Street south of Catfish Creek) and extending southerly to Colin Street from the Township of Malahide; and, THAT County Council authorize staff to enter into an agreement with the Township of Malahide including conditions 1-6 as noted above; and, THAT condition 7 be amended to more clearly recognize the intention for daily patrolling/ monitoring through a combination of Malahide and Elgin personnel (or agents) and to more clearly define the contributions to be made by Malahide in connection with that activity. - Carried. Motion to Adopt Recommendations of the Committee of the Whole Moved by Councillor Jones Seconded by Councillor Wiehle THAT we do now adopt recommendations of the Committee Of The Whole. - Carried. County Council BY-LAW Moved by Councillor Jones Seconded by Councillor Wiehle June 12, 2018 THAT By -Law No. 18-19 "Being a By -Law to Confirm Proceedings of the Municipal Council of the Corporation of the County of Elgin at the June 12, 2018 Meeting" be read a first, second and third time and finally passed. - Carried. ADJOURNMENT Moved by Councillor McWilliam Seconded by Councillor Currie THAT we do now adjourn at 1:16 p.m. and meet again on June 26, 2018 at the County Administration Building Council Chambers at 9:00 a.m. - Carried. Julie Gonyou, David Marr, Chief Administrative Officer. Warden. REPORTS OF COUNCIL AND STAFF June 26, 2018 Staff Reports —(ATTACHED) Manager of Planning — Approval for Official Plan Amendment No. 17 Chief Administrative Officer — Request for Reconsideration — Council Exemption for Woodlands Clearing Application from Fieldstone Investment Inc. Director of Financial Services — May 2018 Budget Performance Director of Financial Services — Capping and Clawback Director of Financial Services — POA Courthouse Tender Results Director of Homes and Seniors Services — Medical Director Agreements — Bobier Villa, Elgin Manor and Terrace Lodge Director of Homes and Seniors Services — Attending Physician Agreements — Bobier Villa, Elgin Manor and Terrace Lodge 9 yiu�wnnU111�� � IAgin! REPORT TO COUNTY COUNCIL FROM: Steve Evans, Manager of Planning DATE: June 7, 2018 SUBJECT: Approval for Official Plan Amendment No. 17 51 Murray Street, Town of Aylmer File No.: AY-OPA17-18 Owner: 10372222 Ontario Ltd. INTRODUCTION: This report will provide County Council with information required in order to consider granting approval to the above noted Official Plan Amendment. The Town of Aylmer submitted Official Plan Amendment No. 17 to the County of Elgin on May 28, 2018 for approval. In accordance with Section 17 of the Planning Act the "Approval Authority" is required to make a decision in which it may approve, modify or refuse to approve an official plan amendment. If the "Approval Authority" fails to make a decision within 180 days after the amendment is received any person or public body may appeal to the Local Planning Appeal Tribunal. (see attachment) DISCUSSION: The lands that are the subject of this application for Official Plan Amendment approval are located at 51 Murray St. and formerly the Aylmer Sales Arena where a farmers and flea market have operated for many years. The purpose of the Official Plan Amendment is to establish a Special Policy Area to permit a public self -storage warehouse within an existing building complex in addition to the uses already permitted in the Arterial Commercial land use designation. The Elgin County Official Plan designates Aylmer as a Tier 1 settlement area where full municipal services are available. The County Official Plan policies direct growth to Tier 1 settlements and supports development within these areas. The Town of Aylmer held a public meeting to consider this Official Plan Amendment on January 15, 2018. There were no members of the public present for the meeting and one letter was received from Catfish Creek Conservation Authority advising that they had no objections to the amendment. The Town of Aylmer received a planning report from its Director of Planning on December 4, 2017 which recommended that Town Council support the applications for Official Plan and Zoning By -Law Amendments for the Aylmer Sales Arena. Based on the information received, Town Council was satisfied that Official Plan Amendment No. 17, as prepared, was suitable for adoption and passed By -Law 09-18 on February 5, 2018 and submitted it to the County of Elgin for approval. 10 Based on the site-specific nature of this Official Plan Amendment and its location within a fully serviced settlement area, it was determined that a full circulation of this amendment to agencies and/or ministries were not required. CONCLUSION: The Council of the Town of Aylmer supports this Amendment and adopted it by By -Law 09-18 on February 5, 2018. The Manager of Planning has reviewed File No. AY-OPA17-18, along with the background material that was submitted by the Town of Aylmer and is satisfied that this Official Plan Amendment is consistent with the Provincial Policy Statement and conforms to both the County of Elgin and Town of Aylmer Official Plans. RECOMMENDATIONS: THAT the Council of the Corporation of the County of Elgin gives approval to Official Plan Amendment No. 17 to the Town of Aylmer Official Plan, File No. AY-OPA17-18; and, THAT staff be directed to provide notice of this decision in accordance with the Planning Act. All of which is Respectfully Submitted Approved for Submission Steve Evans Julie Gonyou Manager of Planning Chief Administrative Officer 11 AMENDMENT NO. 17 TO THE OFFICIAL PLAN FOR THE CORPORATION OF THE TOWN OF AYLMER (51 Murray Street, Aylmer ON) 12 THE APPROVAL PAGE This Amendment to the Official Plan for the Town of Aylmer which has been adopted by the Council of the Corporation of the Town of Aylmer, is hereby approved in accordance with Section 17 of the Planning Act, R.S.O.1990 c. P. 13, as Amendment No. 17 to the Official Plan for the Town of Aylmer. Date, 13 Approval Authority AMENDMENT NO. 17 TO THE OFFICIAL PLAN FOR THE CORPORATION OF THE TOWN OF AYLMER Page BY-LAW NO. 09-18: ADOPTION BY-LAW FOR OFFICIAL PLANAMENDMENT NO. 17 ii CERTIFICATION THAT DOCUMENT ISA TRUE COPY CERTIFICATION OF COMPLIANCE WITH P UBLIC INVOLVEMENT AND NOTICE REQUIREMENTS TFIE CONSTITUTIONAL STATEMENT iv PART A - THE PREAMBLE 1.0 PURPOSE 2.0 LOCATION 3.0 BASIS PART B - THE AMENDMENT 1.0 DETAILS OF THE AMENDMENT 2.0 INTERPRETATION 3.0 IMPLEMENTATION 14 2 2 2 7 ADOPTION BY-LAW FOR OFFICIAL PLAN AMENDMENT NO. 17 CORPORATION OF THE TOWN OF AYLMER BY-LAW NUMBER 09-18 The Council of the Corporation of the Town of Aylmer, under Sections 17 and 21 of the Planning Act, hereby ENACTS as follows: The Official Plan Amendment No. 17 for the Town of Aylmer is hereby adopted. 2. The Deputy -Clerk is hereby authorized and directed to make application to the County of Elgin for approval of the Official Plan Amendment No. 17 for the Town of Aylmer. This By -Law shall come into force and take effect on the day of the final passing thereof. ENACTED AND PASSED THIS 5th DAY OF February, 2018. r Aayor (Corporate Seal) epu T Clerk Certified that the above is a TRUE COPY of By -Law No. 09-18 enacted and passed by the Council of the Town of Aylmer on the 5th day of February, 2018. ii 15 CERTIFICATION THAT DOCUMENT IS A TRUE COPY I hereby CERTIFY that the enclosed document is a TRUE COPY of the Official Plan Amendment No. 17 for the Town of Aylmer as approved by the County of Elgin on the day of 2018. A Mayor (Corporate) Seal) erk pu 1k CERTIFICATION OF COMPLIANCE WITH PUBLIC INVOLVEMENT AND NOTICE REQUIREMENTS I, , / n�hereby CERTIFY that the requirements for the giving of notice, and the holding of at least one public meeting as set out in Subsection 17(9) of the Planning Act, R.S.O. 1990 c. P. 13, and the giving of notice as set out in Subsection 17(17) of the Planning Act, R.S.O. 1990 c. P. 13, have been complied with. (Corporate (Seal) '7 - iii 16 PART A - THE PREAMBLE does not constitute part of this Amendment PART B - THE .AMENDMENT consisting of the following text and map (Schedule "A -l") constitutes Amendment No. 17 to the Official Plan for the Town of Aylmer. 1V 17 PART A - THE PREAMBLE 1.0 PURPOSE The purpose of this Amendment is to change the designation of the lands located at 51 Murray Street (Lots 30 through 36 inclusive, Plan 164) from 'Arterial Commercial' to `Arterial Commercial Special Policy Area AC -2' in the Official Plan. The Amendment is intended to permit the development of a public self -storage warehouse. 2.0 LOCATION The subject lands are located on the north side of Spruce Street east of John Street North in the Town of Aylmer, known municipally as 51 Murray Street (Lots 30 through 36 inclusive, Plan 164). 3.0 BASIS Existing Use The subject lands currently contain buildings and structures associated with a well- established farmers and flea market known locally as the Aylmer Sales Arena. Proposed Use The applicant proposes the development of a public self -storage warehouse within the existing building complex. No additional buildings or site development is proposed at this time. Town of Avlmer Official Plan The subject lands are currently designated `Arterial Commercial' in the Official Plan which does not permit commercial uses of the nature proposed. The applicant has requested a change in land use designation to permit a public self -storage warehouse. This designation change would allow for the proposed development on the subject lands. The proposed development would be subject to the site plan control provisions (Section 6.7) of the Official Plan. Any identified on-site improvements and amenities would be addressed as part of the site plan approval process. An amendment to the Zoning By -Law 59-99 to change the zoning of the subject lands from `site-specific' Support Commercial (C2-4) to `site-specific' Support Commercial (C24) is being addressed concurrently and will implement this Official Plan Amendment upon its approval. Planning Rationale Neighbouring lands are characterized by a mix of predominantly commercial uses (e.g. furniture store, laundromat, car wash, retail store), with low density residential and open space uses also in the vicinity. No expansion to the existing building (exterior design/footprint) is required to accommodate the proposed 20 -unit public self -storage warehouse. The existing farmers market and flea market presently operating from the building is a long-established commercial use which has co -existed with neighbouring uses in excess of thirty years. No significant increases in traffic are anticipated. Existing on-site parking and lighting would be utilized. The visual character and appearance of the site would not be altered. The proposed warehouse facility is considered to be a compatible use and would have no greater impact on neighbouring uses than what presently exists. 18 PART B - THE AMENDMENT All of this part of the document entitled Part B - The Amendment, consisting of the following text and map (Schedule "A-1 ") constitutes Amendment No. 17 to the Official Plan for the Town of Aylmer. 1.0 DETAILS OF THE AMENDMENT The Official Plan of the Town of Aylmer is hereby amended as follows: 1. Schedule "A" to the Official Plan of the Town of Aylmer is hereby amended by changing the designation of those lands described on Schedule "A-1" attached hereto from `Arterial Commercial' to `Arterial Commercial Special Policy Area AC -2'. 2. Section 4.3.2 to the Official Plan of the Town of Aylmer, being ARTERIAL COMMERCIAL AREA, is hereby amended by adding the following to subsection (3) Special Policy Areas: "(b) On lands located on the north side of Murray Street east of John Street North, known municipally as 51 Murray Street, consisting of approximately 9,843 square metres (2.4 acres) of land area and identified on Schedule "A" as `Special Policy Area AC -2', the permitted uses shall include a public self -storage warehouse within the existing building in addition to the uses permitted by the Arterial Commercial Area." 2.0 INTERPRETATION The interpretation of this Amendment shall be in accordance with the respective policies of the Town of Aylmer Official Plan. 3.0 IMPLEMENTATION The implementation of this Amendment shall be in accordance with amendments to the Zoning By -Law, as provided for in Section 6 of the Official Plan of the Corporation of the Town of Aylmer. 2 19 Schedule A-1 Town of Aylmer OFFICIAL PLAN LAND USE PLAN SCHEDULE "A-1" LEGEND //X\ O LOWDEN8ITY RESIDENTW. ft/t.1L.y/ 1WEDIUM DENS17 RESIDENnAL N.T.S. UM41ly/,F HIGH DENSrTY RE81DENTW. CORE COMMERCLLL ARiERIALCOMAIEROIAL AREA AFFECTED BY AMENDMENT No. 17 RM NEIL *=RHOOD CONIMERCNL DUSwEss PARK COMMERCNL m m r r' CHANGE IN DESIGNATION OFFICE REeIbF11TW. FROM `®mrI ME wSMUMNM_ "ARTERIAL COMMERCIAL" TO 771 wOUGTRX "ARTERIAL COMMERCIAL SPECIAL PARN8ANDOPOSPACE POLICY AREA AC -2" MUNICIPALBWNDARY FLOOD UNE •�' OCCAREGULATIONLSAT WATER 20 w, rmllllyij J flgin 1 wrae'h 4dWer 1M',r REPORT TO COUNTY COUNCIL bFCr FROM: Julie Gonyou, Chief Administrative Officer Stephen Gibson, County Solicitor Jeff Lawrence, Tree Commissioner/Weed Inspector DATE: June 19, 2018 SUBJECT: Request for Reconsideration —Council Exemption for Woodlands Clearing Application from Fieldstone Investment Inc. INTRODUCTION: On April 10, 2018, County Council received a report from Jeff Lawrence, Tree Commissioner/Weed Inspector, which provided details of a Council Exemption for Woodlands Clearing Application received from Fieldstone Investments Inc. ("Fieldstone"). In their application, Fieldstone Investments Inc. requested permission to clear 3.2 hectares of woodland for the purpose of converting woodland to farmland on South Part Lot 9, Concession 2 in the Municipality of Dutton Dunwich. The commissioner presented a report recommending that Council approve the Clearing Exemption Application from Fieldstone, conditional on the applicant contributing $16,800 to a tree planting fund administered by the County for the planting of 5,600 seedling trees within the Municipality of Dutton Dunwich. At this meeting, County Council rejected the Exemption for Woodlands Clearing Application from Fieldstone to clear 3.2 hectares of woodland. A letter was sent to Mr. Groenewegan following the meeting notifying him of Council's decision. BACKGROUND: On May 22nd, 2018 County Council received correspondence from Mr. Groenewegan (Fieldstone Investments Inc.) requesting County Council's reconsideration of his request as presented to County Council on April 17th, 2018 stating that no reasons for denial of tree clearance were included in the resolution. County Council received the correspondence and the following resolution was passed: WHEREAS County Council considered the request for tree clearance from Mr. Groenewegan at their meeting on April 17, 2018; and, WHERAS section 40) By -Law No. 05-03 states that reasons for denial of tree clearance requests be provided to the applicant; and, WHEREAS no such reasons were provided to the applicant in correspondence sent to the applicant on April 18, 2018; and, WHEREAS the Ontario Municipal Board is undergoing change to name and jurisdiction; and, 21 WHEREAS the appeal process for tree clearance has been deleted from the Municipal Act. NOW, THEREFORE, BE IT RESOLVED BY COUNTY COUNCIL: THAT the Chief Administrative Officer be directed to have the request for reconsideration be forwarded to the County Solicitor for a review process; and, THAT the Chief Administrative Officer be directed to inform the applicant, Mr. Groenewegan of County Council's direction. DISCUSSION: Reconsideration as contemplated by the Woodlands Conservation By -Law doesn't apply to this situation. Reconsideration within the By -Law is, in reality, a Council review process when the decision in first instance is made at the Clerk level. In the matter again now before you, the original decision was made by Council and the complaint now being lodged is not that the original decision was wrong on its merits but rather that the reasons for that decision are not sufficiently set forth in either the Resolution of Council or the notice letter delivered to the applicant. An alternative process is the motion to rescind. In meetings of a deliberative assembly, motions to rescind (or "repeal" or "annul") and amend something previously adopted are used to change action that was taken. Under Robert's Rules of Order, the rules for this motion protect against instability arising from small variations in attendance from one meeting to the next. For this reason, the requirements for changing a previous action are greater than those for taking the action in the first place. A motion to rescind, repeal, annul or amend something already adopted requires a two- thirds vote, a majority vote with previous notice, or a vote of a majority of the entire membership, any one of which would suffice. CONCLUSION: It is accepted that insufficient reasons for the original decision of Council to reject the Fieldstone Application were incorporated within the Council resolution of April 10, 2018, and the subsequent notice letter delivered to Fieldstone Investments Inc. To that extent, the decision-making in respect of the Fieldstone Application is flawed. To address the flaw in the previous decision-making process, it is recommended: THAT the report titled "Request for Reconsideration — Council Exemption for Woodlands Clearing Application from Fieldstone Investment Inc." from Chief Administrative Officer and County Solicitor, dated June 19, 2018 be received and filed; and, THAT Elgin County Council rescind the following motion from April 10th 2018- 22 THAT County Council reject the Exemption for Woodlands Clearing Application from Fieldstone Investments Inc. to clear 3.2 hectares of woodland. As Moved by Councillor Jones Seconded by Councillor Wiehle; and, THAT Elgin County Council reconsider Fieldstone Investments Inc.'s Council Exemption for Woodlands Clearing Application at their meeting on July 24, 2018, and that notice of intended reconsideration of the Application by Fieldstone Investments Inc. be delivered to the Applicant and to any other person or entity that received a similar notice in respect of its original consideration by Council on April 10, 2018. All of which is Respectfully Submitted Julie Gonyou Chief Administrative Officer Stephen Gibson County Solicitor Jeff Lawrence Tree Commissioner/Weed Inspector 23 w, rmllllyij J flgin 1 wrae'h 4dWer 1M',r REPORT TO COUNTY COUNCIL bFCr FROM: Jim Bundschuh, Director of Financial Services DATE: June 18, 2018 SUBJECT: May 2018 Budget Performance INTRODUCTION: Attached is the May budget comparison for the County with favourable performance for the month of $69,000. DISCUSSION: The favourable performance for the month of May brings the year-to-date favourable performance to $196,000. The Homes had negative performance of $20,000 resulting from overtime stemming from recruitment issues in the nursing departments. This was more than offset by a return of surplus from the Health Unit of $44,000, the sale of surplus ambulances of $18,000 and favourable performance in Economic Development for Planning fees of $14,000. RECOMMENDATION: THAT the report titled "May 2018 Budget Performance" dated June 18, 2018 be received and filed. All of which is Respectfully Submitted Approved for Submission Jim Bundschuh Julie Gonyou Director of Financial Services Chief Administrative Officer 24 N m V LO 0 I— 00 O 0 N CO V LO (0 I— 00 O N N N NCO N LO N co N m U) 0 c E a) 0) m c 00 so ' N (0 O co O O O V O O N N co O I— co V V N O (0 CO O I— 00 I— 00 0) [,- 00 ' ' ' ' O V N (0 (0 O O co (0 V co ' (0 (0 ' M I* L N C7 co N L 06 N N C M O N co +, a 00 (0 I-- V N N O N CO (0 O ('� N I� LO O O 1- ' r co N M ' ' ' O 00 O N N V 00 LO O O V O O N LO ' M ++ N I-- Lo 00 N_ 00 O O N V (6 O V N O LO C7 O r- I— V r- r- (0 O = Lo O C7 N LO 1 00 V O I-- LO co co 00 +� +� z O N N O N V V (0 = LO CO N (0 a0 I --a0 v 0) C14 0) r L O O N m V 0) LO LO V co 00 O I— 1— O LO LO co O r O N O O I� v CO LO O N O V I-- O 00I-- N CO O r co U ai N I— O N_ 00 r O I— O N O ch O 00 00 (0 co 00 = 00 O O ++ .... 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Q 4-0 �! W J Cl) J W U z O W Cl) p z Q 0 Cl) Q J H z H W Q W U p Z z Q Z Z L11 W Q> W J Z O X W U Q Q z 0 0 O Q cr O Cl) T- O O J m O a z O w w T z o p z_ p p O z O m_ z Ir O U O O Uo m Q H Cl) S U' Of m O m H >Q > Q LL S Q U W S 5 J— 0- U Q W H H N m V LO 0 I— 00 O 0 N CO V LO (0 I— 00 O N N N NCO N LO N co N m U) 0 c E a) 0) m c 00 so w, rmllllyij J flgin 1 wrae'h 4(Wer 1M',r REPORT TO COUNTY COUNCIL bFCr FROM: Jim Bundschuh, Director of Financial Services DATE: June 26, 2018 SUBJECT: Capping and Clawback INTRODUCTION: Each year Council has the opportunity to review its current tax policy. DISCUSSION: When CVA assessment was introduced in 1998, the goal was to have fair taxation in which properties of equal value would pay equal taxes. This new system created an outcry amongst property owners that had previously enjoyed relatively lower taxes in comparison to their neighbours. Despite the fact that this new system was ultimately fairer than the prior system, the significant increase in taxes for some properties caused by the transition was a concern. As a result, the province introduced a capping and clawback program to soften the blow. Under the capping program, properties owners that previously were paying taxes lower than their property's CVA taxes had their tax increases capped to a manageable increase. Since the capping/clawback program is revenue neutral, those properties that had been paying taxes below their CVA tax level bear the cost of the capping program through clawbacks. These properties are enjoying reductions in their taxes, but not to the full extent due to this clawback feature of the program. The workload of the program becomes less each year. In fact for 2018 there remain only 9 commercial and no industrial properties in the program. Elgin County exited the multi -residential capping program in 2016. In 2019, the County will be eligible to exit industrial capping. The province introduced a new tax tool in 2017 to allow municipalities to exclude reassessment related increases from the capping calculation. The other tools previously utilized by Elgin County include excluding properties from the program if they crossed over from capped to clawed back, or vice versa. Once a property is at CVA tax, they will stay at CVA tax. The county also selected the option that would exclude properties from the capping program if the amount of the cap was below $500. Also selected was the option that would exclude properties from a clawback if the amount of the clawback was below $500. Previously the maximum for the Prior Year CVA Tax Limit was set to 10%. The local treasurers recommend that all these optional tools be utilized to their full extent. CONCLUSION: The local treasurers were polled regarding the capping options and all agree upon the following options: a) Set the annualized tax limit increase to a maximum of 10%; 26 b) Set an upper limit on annual increases at the greater of the amount calculated under a) and up to 10% of the previous year's annualized CVA tax; c) Establish a capping adjustment threshold of up to $500 for increasing properties, decreasing properties or both, whereby no capping/clawback adjustments less than the threshold amount would be applied; d) Exclude properties that were at CVA tax in the previous year from the capping and clawback calculation in the current year; e) Exclude properties that would move from being capped in the previous year to be clawed back in the current year or from being clawed back in the previous year to be capped in the current year as a result of the changes to the CVA tax; and f) Exclude reassessment related increases from the capping calculation. RECOMMENDATIONS: THAT County tax policy set the annualized tax limit increase at 10%; the prior years current value assessment (CVA) tax limit increase at 10%; the CVA threshold for protected (increasing) properties at $500; the CVA threshold for clawed back (decreasing) properties at $500; exclude properties that were at CVA tax in the previous year from the capping and clawback calculation in the current year; and exclude properties that would move from being capped in the previous year to be clawed back in the current year or from being clawed back in the previous year to be capped in the current year as a result of the changes to the CVA tax; and, exclude reassessment related increases from the capping calculation; and, THAT the necessary by-laws be adopted. All of which is Respectfully Submitted Approved for Submission Jim Bundschuh Julie Gonyou Director of Financial Services Chief Administrative Officer 27 PROVINCIAL OFFENCES ADMINISTRA�TION FACILITY w a a we get to today? A A w w A w • The courtroom is undersized. • The waiting room is disjointed from the courtroom. • The halls are overcrowded, dark, and not properly heated and cooled. a Sound carries into the courtroom from the halls and the waiting room, disturbing proceedings. a Justice of the Peace access is not secure. • No holding cells for persons in custody — movement is through public hallway, officer and public safety concerns. • Customer service counters are ineffective. • Staff do not have secure access to and from courtroom or building. • Court services are not accessible. 29 CIX Review of County space and facility needs performed by Management Team. Report to County Council on July 13, 2010 in regards to overcrowding and congestion on court days, with short-term measures that were taken to offset the issues. County Council authorized for the examination of options which included: Renovations within the building envelope. An addition or link to the existing building. to New building for POA and Museum on vacant lot. to Seeking space in the provincial space on Wellington Street. to Taking over the temporary space on Silver Street when the Province was finished with it. 31 NM • Plans were provided for a joint Museum and POA Facility. • Council approved in principle the development of a new facility by the year 2017 for POA and Museum Services, with funding being sought for the Museum. • Council approved that the Provincial Offences Court Space needs proceed regardless of the outcome of Museum funding. a Council approved development of plans that would encompass a new POA facility to be built on County property by 2017 and be scalable to permit the construction of a County Museum with achieved funding. POA facility to include two courtrooms, one of which was to be a jointly used as Council Chambers and second courtroom. 32 am Plans were presented to Council with options for: Renovation within existing building. to A linked facility between Administration Building and new POA/Museum Building. to Stand alone POA/Museum facility. Plans were deferred until Museum grant opportunities were fully explored. 1 Council directed staff to seek a threat assessment from the province on the POA Facility. Council requested a second inquiry be made of the province to lease space at the Wellington Street location. 33 The Ministry offered only the option to lease space at Wellington Street on a per diem bases for lengthy special trials that cannot be accommodated within the County's POA facilities or for emergency situations. 0 Council directed staff to negotiate a contract for per diem lease space. q" 0 Staff continue to negotiate a contract for per diem lease space. 0 Council directed staff to evaluate the facility needs for POA for both function and security and provide recommendations once POA Modernization outcomes are known. 0 Once Modernization outcomes were known staff was to refine the POA facility needs, reducing the facility to one court room with the ability to add a second one. 0 On December 11, 2017 the budget of 3.5 million was presented. c What options did we have an why didn't they work? I -- Renovate within current building envelope. Link or add on to this building. Seek space at Wellington Street Court. Taking over Silver Street temporary location. Joint POA/Museum Facility. All new County Administration Building to accommodate all services. • Would not achieve the security and functionality that are required for POA within this building envelope. • Attaching or linking to this building is not cost effective. 35 Province is not interested in leasing space in this manner. In fact they are moving away from all shared facilities with POA, the only ones existing are those where the Ministry leases from the Municipality. Per Diem was only offer available to us. This space was larger than our needs and is no longer available. Museum went ahead with funding, while POA was seeking space at Wellington Street. Additional capital cost for office space was prohibitive. 1 • POA Steering Committee worked with the architect from +VG to develop plans for stand alone POA Facility. • An expression of interest to bid was done in December, 2017. • Pre -Qualification for contractors was issued in January. The tender went out to those who pre- qualified on May 2, 2018 and closed on May 30,02018. The successful low bid was Southside Group at 1.6 million over budget. 36 w, rmllllyij J flgin 1 wrae'h 4dWer 1M',r REPORT TO COUNTY COUNCIL bFCr FROM: Jim Bundschuh, Director of Financial Services DATE: June 20, 2018 SUBJECT: POA Courthouse Tender Results INTRODUCTION: The April 11, 2017 "POA Court Facilities" report to Council reviewed the response from Ministry of the Attorney General (MAG) regarding leasing court space at Wellington Street. MAG was willing to lease court space on a per diem basis for special trials/situations but would not lease courts/offices for ongoing operations. A subsequent report to Council dated August 29, 2017 was approved recommending "THAT staff be directed to work with the approved architect to refine the POA facility needs for construction in spring of 2018." The last related report to Council dated December 11, 2017 recommended that the budget for the project be $3.5 million based on using the lower end of construction rate estimates provided by the Ventin Group of $330 per square foot (psf). Ventin Group warned of the risk of construction costs escalating as the availability of trades appeared to be becoming scarce. Rather than speculating on future pricing, $330 psf, based on current pricing levels, was used for budget purposes. DISCUSSION: Of the 14 pre -qualified contractors only four submitted tenders on May 30 with the lowest tender (Southside Construction) being just under $470 psf (including furniture - see Attachment 1). This cost considerably exceeds the price range provided by Ventin in December and is resulting in a total project cost of $5.4 million, an increase of $1.9 million versus the approved budget. This increase is explained by $1.6 million in increased costs due to the market conditions and $0.3 million due to a risk associated with storm water management. An investigation of recently tendered projects provides some insight. Burlington is currently building a 40,000 square foot courthouse at $400 psf. Most of the project was tendered last year prior to the escalation of pricing and they benefit from economy of scale. Niagara Region built the 20,000 square foot Welland POA Facility tendered in 2016 at $470 psf. Haldimand County closed tenders this spring on two projects: an administration building at $320 psf, and a library/heritage centre at $432 psf. The administration building benefited from office finishing cost versus court facility finishing costs, as well as from the economies of scale, being four times the size of Elgin's project. Court facility costs would be expected to be significantly higher given the cost of finishing in a courtroom and the cost of required prisoner detention facilities. Haldimand's library facility/heritage centre is close in size to Elgin's court facility with a tender price that is also comparable. 37 Retendering in the fall is an option but this would likely only be beneficial if market conditions improve. It is difficult to speculate where the economy will be heading in a few months' time, and similarly difficult to speculate whether revised bids would be lower or higher. The Steering Committee is not recommending this option. Included in the tenders were options for alternatives (siding, courtroom finishes, heated sidewalk and full -building sprinklers) that would, if chosen, add a further $137,000. Given the substantial increase in pricing, the Steering Committee is not recommending including these alternatives in the construction project. The Steering Committee requested that Southside Construction provide suggestions as to how substantial cost reductions might be achieved. The net savings identified by Southside of $300,000 are shown in Attachment II. Given that net revenue from POA is not retained by the County, but instead benefits the local municipalities including the City of St. Thomas, the cost associated with the new construction will ultimately impact the net revenue provided to the local municipalities. In 2017 the gross revenue from fines/collections was $1.8 million with expenses of $1.2 million resulting in municipal partner net revenue of $0.6 million, with approximately 40% going to the City. Amortization on the budgeted project costs of $3.5 million would have increased the total annual expenses by $125,000 and the tender costs of $5.1 million would add a further $50,000. As a result, the local partner net revenue starting in 2020 would likely be approximately $0.4 million. The local municipalities have been informed of this potential impact pending Council approval to proceed. When the courts were downloaded to the County in 2001, it was understood that the admin building courtroom was a temporary situation. The local municipalities have enjoyed a windfall for an extended period, but without proper facilities being provided going forward, the municipalities risk MAG responding unfavourably. MAG could refuse to hold proceedings until the facility meets standards thereby forcing the County to build and be subject to even higher rates, or MAG could potentially revoke Elgin County's management of POA. If Elgin loses the POA operation it would result in the local partners losing all the fines/collections revenue. Therefore, it is prudent to proceed currently with the project. Of course, everything that can be done to find cost efficiencies/savings in the construction project needs to be pursued to benefit Elgin's local partners. CONCLUSION: The lowest bidder was asked to identify potential cost savings to reduce the current $475 psf cost of the project, with Southside identifying net savings of $300,000. Including cost savings, the project is $1.6 million over budget, predominately because of current market conditions driving higher than expected pricing. Currently, discussions are underway with Central Elgin to investigate storm water solutions. If some or all of the risk of storm water can be eliminated, the budget overage could be reduced by up to $0.3 million. M RECOMMENDATIONS: THAT POA Court Facility project be awarded to the Southside Construction for $4,553,000; and, THAT staff be directed to implement cost saving measures with Southside Construction of approximately $300,000; and, THAT staff be directed to investigate storm water management solutions with Central Elgin; and, THAT the local municipal partners be informed of the award of tender and the change notice for the POA Facilities project. All of which is Respectfully Submitted Approved for Submission Jim Bundschuh Julie Gonyou Director of Financial Services Chief Administrative Officer 39 Attachment I POA Courthouse Costing Summary June 12, 2018 Tender Results Southside Construction $4,553,000 Graceview Enterprises $4,730,000 Jasper Construction $5,144,000 M.J. Dixon Construction $5,273,000 Total Project Cost 2018 Budget 30 -May -18 Hydro Service Costs per sq/ft Costs per sq/ft Base Cost $3,157,328 $332 $4,553,000 $459 Furniture inc. in Div 12 of base cost $8 100,000 $10 Permits 17,000 17,000 Storm Water Management Risk 140,000 300,000 Ventin Group 243,114 350,581 Ventin Group Disbursements 3,000 3,000 Subtotal 3,420,442 5,323,581 HST Unrebated 60,200 93,695 Current costs $3,480,642 $5,417,276 Cost Savings Opportunities $301,730 Net Expected Costs $5,115,546 Memo: Included in Base Costs Cash Allowances Inspection and Testing $20,000 $15,000 Hydro Service 10,000 35,000 Natural Gas 20,000 25,000 Hardware 50,000 64,000 Access Control and CCTV 67,000 Contingency Allowance 140,000 140,000 .N POA Courthouse Cost Savings June 12, 2018 Architectural 1) Provide 50/50 bonding in lieu of 100/50 with a 12 month maintenance period. 2) Delete project construction sign. 3) Delete professional photographs. 4) Delete work to Cell 110 and Interview 112. Work deleted to include Cell Door 110 complete with glazing and hardware, swivel stools, chase door frame and hardware, modesty panels, speak-thru, interior walls, epoxy flooring, epoxy wall coating, acoustic ceiling, toilet, sink and bench heating. 5) Delete louvered roof top screen support. Work deleted to include HSS upstands, angled support, steel support below, roofing and louvres. No unit mounted louvres have been included with this pricing. (See attached highlighted drawing showing structural steel deleted.) 6) Delete precast concrete bumper curbs. 7) Delete tree transplanting. Transplanting to be done by Owner. 8) Revise roofing specification and scope of work. Roof to be changed to a So pre ma 2 ply hot applied asphalt with mechanically fastened deck sheathing. Warranty included would be a 10 year manufacturer's system warranty plus a 2 year Ontario Industrial Roofing Contractors Association warranty. 9) Change flag poles to standard 25 foot poles. 10) Delete ground louvre screen and replace with wood privacy fence. Mechanical 10) Delete BAS (controls)* 11) Reduce boiler capacity to serve current footprint only. 12) Provide in -slab piping only for future in -slab heating. Rigid insulation has been included in this price as well. 13) Replace current two air handling units design with more conventional roof top units. Four units should be sufficient. V+R to be involved with Barrett Mechanical. This price is for Mechanical only. There could be additional costs for steel, roofing and electrical should this option be considered. 41 Cost Savings Potential $ 11,400.00 1,500 2,500 19,500 23,400 1,200 6,600 30,200 2,500 8,500 118,750 9,770 (18,500) 62,300 Attachment II POA Courthouse Cost Savings June 12, 2018 Electrical Cost Savings Potential 14) Revise routing of secondary hydro service and empty 5,010 communication conduit. 15) Delete generator, transfer switch and pad. Provide rough -in 97,100 for future leaving stake at the end of the conduit. Sub -Total 381,730 Owner Costs (primarily related to BAS Controls) (80,000) Net Savings W, $ 301,730.00 Attachment II yiu�wnnU111�� � IAgin! REPORT TO COUNTY COUNCIL FROM: Michele Harris, Director of Homes and Seniors Services DATE: June 18, 2018 SUBJECT: Medical Director Agreements — Bobier Villa, Elgin Manor and Terrace Lodge INTRODUCTION: The Medical Director agreement for Elgin Manor and Bobier Villa expired March 2018. The Medical Director agreement for Terrace Lodge expires June 2018. DISCUSSION: The current Medical Director agreements include provisions for an option of renewal for one (1) subsequent two (2) year period. Having regard for the elections in 2018 which may impact Long -Term Care Home services and funding, negotiations with the current Medical Directors (Dr. Derek Vaughan and Dr. Michael Toth) regarding a one (1) year renewal occurred. Additionally, the Director of Homes and Seniors Services has scheduled meetings with the individual Medical Directors, to provide an opportunity for discussion regarding the requirements of the Long -Term Care Homes Act, 2007 and Ontario Regulation 79/10 as they related to the role of the Medical Director, opportunities for improvement, quality indicators, etc. The one (1) year agreement renewal timeframe should be sufficient to allow for appropriate review and assessment of the potential impact of any provincial changes to both funding and service requirements. CONCLUSION: Staff is recommending a one (1) year renewal agreement for the Medical Director positions for Bobier Villa, Elgin Manor and Terrace Lodge. Negotiations with the current Medical Directors support a one (1) year renewal is a viable option. RECOMMENDATIONS: THAT Council authorize staff to sign the one (1) year agreement from April 1, 2018 to March 31, 2019 with Dr. Derek Vaughan for the provision of Medical Director Services to Bobier Villa and Elgin Manor; and, THAT Council authorize staff to sign the one (1) year agreement from July 1, 2018 to June 30, 2019 with Dr. Michael Toth for the provision of Medical Director Services to Terrace Lodge. All of which is Respectfully Submitted Approved for Submission Michele Harris Julie Gonyou Director of Homes and Seniors Services 43 Chief Administrative Officer MEDICAL DIRECTOR AGREEMENT THIS AGREEMENT made this day of BETWEEN: E CORPORATION OF THE COUNTY OF ELGIN (hereinafter referred to as the "County") DEREK VAUGHAN (hereinafter referred to as the "Medical Director") , 2018. WHEREAS the County desires to appoint a Medical Director for its long-term care home known as Bobier Villa and situated in the Municipality of Dutton Dunwich, Ontario (hereinafter the "Home"); AND WHEREAS the Long -Term Care Homes Act, 2007 requires that there be a contract between the County and its Medical Director; AND WHEREAS the Medical Director wishes to enter into an Agreement with the County to perform the services described herein. NOW THEREFORE in consideration of the covenants and agreements hereinafter contained, the sufficiency of which is hereby acknowledged, the parties agree as follows: 1.0 The County shall: 1.1 Pay a fee to the Medical Director for the provision of professional services provided by the Medical Director, provided such fee is in accordance with the fee for such services as established by the Ministry of Health and Long -Term Care (MOHLTC) and provided further that any adjustments to this fee, as approved by the Ministry of Health and Long -Term Care, will be paid to the Medical Director immediately and/or retroactively to the effective date of such annual adjustments as approved by the Ministry of Health and Long -Term Care. 1.2 Provide the Medical Director with cellular telephone to provide on-call service to the Home and as agreed to by the Director of Homes and Seniors Services for the County. 1.3 Calculable in accordance with County policy in existence from time to time, pay mileage incurred for return travel from St. Thomas to Bobier Villa for the provision of services of Medical Director. 1.4 As currently available to non-union employees of the County of Elgin and revised from time to time, provide Extended Health Benefits, including dental, semi -private hospital, deluxe travel, prescription drug, vision, hearing aid, and paramedical practitioner coverage, to the Medical Director and his eligible dependents; provided that the availability and specific extent of such coverage and benefits shall be subject to the terms and conditions and limitations applicable to same for non-union employees of the County. 1.5 Following the expiry of the term of this Agreement or any renewal thereof, the Medical Director may, at his own cost, convert any afore -mentioned health benefits available at the time of expiry of the term of this Agreement or any renewal thereof to an individual plan available to non -unionized employees of the County of Elgin but subject to any criteria then in effect at the instance of the carrier of such health benefits and options, noting that the general provisions for such health benefits currently in place provide, in part, as follows: "If your employment with the Employer terminates, you have the right to convert your coverage to an individual plan without providing Proof of Good Health. In addition, if one of your Dependents ceases to qualify as a Dependent under the Policy, he or she also has the right to convert coverage to an individual plan without providing Proof of Good Health. In order to apply for an individual plan of coverage, the person must submit a written application and the required premium to the insurer within 60 (sixty) days of the date the group coverage is terminated. The individual plan will be exchanged for all benefits on the person under this group benefit plan. The coverage under the individual plan will not duplicate the coverage under this group benefit plan and is subject to the terms and conditions of the individual plan being offered at that time. " 1.6 Ensure that the County's liability insurance coverage for Directors of the Corporation shall be extended to the Medical Director as provided by the Insurance Carrier and adjusted from time to time. 1.7 Pay the Medical Director's fees (registration fees, accommodation costs, travel expenses, etc.) for continuing medical education and medcial conferences to a yearly allocation of $2,000.00 in accordance with the County's convention attendance policy. 2.0 The County agrees to indemnify and save harmless the Medical Director from any claims, demands, damages or actions brought against the Medical Director in relation to the provision of service by employees of the Home who are not acting under the instructions of or under the direction of the Medical Director. 3.0 The Medical Director shall: 3.1 At all times be a medical doctor licensed by the College of Physicians and Surgeons of Ontario; 45 3.2 Obtain and maintain in full force and effect during the term of this Agreement, current, valid and adequate medical malpractice protection and insurance, and upon request, provide proof of such protection and insurance to the County; 3.3 Be accountable to the Director of Homes and Seniors Services / Designate for the County and, furthermore, be responsible for providing advice to the said Director on matters relating to medical care in the Home, including but not limited to the development, implementation, and evaluation of medical services in the Home and further including but not necessarily limited to the following: • ethical dilemmas; • safety /risk management; • resident care programs, with special consideration of the resident population language, culture, and care needs; • diagnostic services; • pharmacy and therapeutic; and • drug profiles and emergency on-call provision of care 3.4 Provide advice, when requested, to the Director of Homes and Seniors Services / Designate for the County on matters pertaining to medical care and services, including but not limited to the following: • organizing of medical services; • credentialing of physicians; • physician membership in appropriate associations; • continuing medical education; • annual review; and • arranging for medical care for residents without attending physicians. 3.5 Have the responsibility and authority to monitor and evaluate the medical care and services provided by physicians in the Home and to take action when expected to do so when standards are not met; 3.6 Be available to visit the Home at a minimum of once per week in order to carry out his or her responsibilities under this Medical Director Agreement; 3.7 Assist the Home with emergency medical services for residents in the event of disaster / evacuation; 3.8 Participate in quarterly Professional Advisory Committee (PAC); 3.9 Provide recommendations as requested on the Long -Term Care Home Quality Improvement Plan (LQIP) relative to the Home to the Continuous Quality Improvement Team; 3.10 Follow and adhere to all County policies and procedures including but not limited to the following: .E • confidentiality; • code of conduct; • conflict of interest; and • all relative policies according to the legislative requirements for the Home. 3.11 Participate as requested in investigations, inquiries or hearings as may be required by the Administrator of the Home / Director of Homes and Seniors Services related to allegations of abuse, violations of the residents' bill of rights or professional misconduct. The Medical Director shall when requested: 4.1 Participate in the review of Community Care Access Centre applications; 4.2 Participate in special care conferences related to resident issues that may put other residents, staff or visitors at risk; 4.3 Conduct an annual review of medical policies and make recommendations for improvement of same; 4.4 Provide medical liaison with local hospital(s) and other appropriate health care organizations or any long-term care home; 4.5 Participate in Infection and Control meetings and Continuous Quality Improvement (CQI) Meetings as requested, within the Home; 4.6 Co-operate with and/or be available during compliance reviews pertaining to medical issues, including inquiries made by the Ministry of Health and Long - Term Care Inspector, advocates, family members, and persons conduction coroner's investigations; and 4.7 Sign an Attending Physician's Agreement if the Medical Director is also an Attending Physician at the Home. 5.0 In the event that the Medical Director is temporarily unable to attend the Home at any time, the Medical Director shall so notify the Director of Homes and Seniors Services / Designate for the County of the name of his or her designate, if one is available, in advance of such unavailability. 6.0 The parties hereto acknowledge and agree that any research projects conducted at the Home will be permitted provided that such project meets approval of the Director of Homes and Seniors Services / Designate and is permitted by legislation. Publication or discussion of any research data collected from the Home must receive prior approval of the said Director. Any and all research projects undertaken at the Home must meet current ethical research and scientific standards. Furthermore, any research project must comply with the requirements of current privacy legislation. The Medical Director agrees to cooperate with and in any such research project as 47 approved by the Director of Homes and Seniors Services / Designate for conducting within the Home. 7.0 Except as provided for herein, this Agreement shall remain in force for a period of one (1) year from the date first written above. 8.0 This Agreement may be terminated by either party on at least one hundred and twenty (120) days written notice to the other; provided that, in the event of default in respect of any obligation hereunder, this agreement may be terminated on sixty (60) days written notice by the party not in default to the party in such default, within which sixty (60) day period the party in default shall have seven (7) days to end and/or remediate such default. 9.0 Notwithstanding that set forth in section 8.0 above, in the event that the Medical Director becomes unable to perform his duties for a period of one hundred twenty (120) consecutive days due to physical, psychological or mental illness or condition, the County may terminate this Agreement on thirty (30) days written notice to the Medical Director. 10.0 With the participation of the Medical Director, the Director of Homes and Seniors Services / Designate shall conduct an annual review to determine if the Medical Director is satisfying and complying with the terms and conditions of this Agreement and, if it is determined that the Medical Director is failing to satisfy and/or comply with such terms and conditions, the County shall be at liberty to terminate this Agreement pursuant to section 9.0 above. 11.0 In the event of death of the Medical Director, the within Agreement shall be deemed to be terminated as of date of such death. 12.0 In the event of termination of this Agreement as provided for above and in addition to any other entitlements provided for herein, the County shall pay to the Medical Director or his Estate, as the case may be, any and all amounts owing to and accruing to the benefit of the Medical Director up to and including the date of such termination. 13.0 This Agreement may be amended by written agreement signed by the parties and attached hereto, and such amendments shall be adhered to and have the same force as if they had originally formed part of this Agreement. 14.0 Any notice required by or contemplated under this Agreement shall be given in writing and shall be delivered personally as follows: (a) To the County at: (b) To the Medical Director: 450 Sunset Drive St. Thomas, ON N5R 5V1 1063 Talbot Street St. Thomas, ON N5P 1 G4 Each party may change its address for delivery under this Agreement by notice to the other party. 15.0 The Medical Director shall not assign his or her interest in this Agreement without first receiving the written consent of the County. 16.0 The parties hereto shall execute such further assurances as the other party shall reasonably be required to give effect to this Agreement. 17.0 This Agreement shall be binding upon and enure to the benefit of the parties hereto and their respective permitted successors. IN WITNESS WHEREOF the parties hereto have executed this Agreement under hand and seal at St. Thomas, Ontario this day of , 2018. Signed, Sealed, and Delivered In the Presence of Witness: Name: Per: Per: Per: Corporation of the County of Elgin Name: David Marr Position: Warden Name: Julie Gonyou Position: Chief Administrative Officer Name: Michele Harris Position: Director of Homes and Seniors Services We have the authority to bind the Corporation Derek Vaughan Per: Name: Derek Vaughan Date: , 2018 CORPORATION OF THE COUNTY OF ELGIN DEREK VAUGHAN Medical Director Agreement (Bobier Villa) Michele Harris Director of Homes and Seniors Services 450 Sunset Drive St. Thomas, ON N5R 5V1 50 MEDICAL DIRECTOR AGREEMENT THIS AGREEMENT made this day of , 2018. BETWEEN: CORPORATION OF THE COUNTY OF ELGIN (hereinafter referred to as the "County") DEREK VAUGHAN (hereinafter referred to as the "Medical Director") WHEREAS the County desires to appoint a Medical Director for its long-term care home known as Elgin Manor and situated in the Township of Southwold, Ontario (hereinafter the "Home"); AND WHEREAS the Long -Term Care Homes Act, 2007 requires that there be a contract between the County and its Medical Director; AND WHEREAS the Medical Director wishes to enter into an Agreement with the County to perform the services described herein. NOW THEREFORE in consideration of the covenants and agreements hereinafter contained, the sufficiency of which is hereby acknowledged, the parties agree as follows: 1.0 The County shall: 1.1 Pay a fee to the Medical Director for the provision of professional services provided by the Medical Director, provided such fee is in accordance with the fee for such services as established by the Ministry of Health and Long -Term Care (MOHLTC) and provided further that any adjustments to this fee, as approved by the Ministry of Health and Long -Term Care, will be paid to the Medical Director immediately and/or retroactively to the effective date of such annual adjustments as approved by the Ministry of Health and Long -Term Care. 1.2 Provide the Medical Director with cellular telephone to provide on-call service to the Home and as agreed to by the Director of Homes and Seniors Services for the County. 1.3 Calculable in accordance with County policy in existence from time to time, pay mileage incurred for return travel from St. Thomas to Elgin Manor for the provision of services of Medical Director. 1.4 As currently available to non-union employees of the County of Elgin and revised from time to time, provide Extended Health Benefits, including dental, 51 semi -private hospital, deluxe travel, prescription drug, vision, hearing aid, and paramedical practitioner coverage, to the Medical Director and his eligible dependents; provided that the availability and specific extent of such coverage and benefits shall be subject to the terms and conditions and limitations applicable to same for non-union employees of the County. 1.5 Following the expiry of the term of this Agreement or any renewal thereof, the Medical Director may, at his own cost, convert any afore -mentioned health benefits available at the time of expiry of the term of this Agreement or any renewal thereof to an individual plan available to non -unionized employees of the County of Elgin but subject to any criteria then in effect at the instance of the carrier of such health benefits and options, noting that the general provisions for such health benefits currently in place provide, in part, as follows: "If your employment with the Employer terminates, you have the right to convert your coverage to an individual plan without providing Proof of Good Health. In addition, if one of your Dependents ceases to qualify as a Dependent under the Policy, he or she also has the right to convert coverage to an individual plan without providing Proof of Good Health. In order to apply for an individual plan of coverage, the person must submit a written application and the required premium to the insurer within 60 (sixty) days of the date the group coverage is terminated. The individual plan will be exchanged for all benefits on the person under this group benefit plan. The coverage under the individual plan will not duplicate the coverage under this group benefit plan and is subject to the terms and conditions of the individual plan being offered at that time. " 1.6 Ensure that the County's liability insurance coverage for Directors of the Corporation shall be extended to the Medical Director as provided by the Insurance Carrier and adjusted from time to time. 1.7 Pay the Medical Director's fees (registration fees, accommodation costs, travel expenses, etc.) for continuing medical education and medcial conferences to a yearly allocation of $2,000.00 in accordance with the County's convention attendance policy. 2.0 The County agrees to indemnify and save harmless the Medical Director from any claims, demands, damages or actions brought against the Medical Director in relation to the provision of service by employees of the Home who are not acting under the instructions of or under the direction of the Medical Director. 3.0 The Medical Director shall: 3.1 At all times be a medical doctor licensed by the College of Physicians and Surgeons of Ontario; 52 3.2 Obtain and maintain in full force and effect during the term of this Agreement, current, valid and adequate medical malpractice protection and insurance, and upon request, provide proof of such protection and insurance to the County; 3.3 Be accountable to the Director of Homes and Seniors Services / Designate for the County and, furthermore, be responsible for providing advice to the said Director on matters relating to medical care in the Home, including but not limited to the development, implementation, and evaluation of medical services in the Home and further including but not necessarily limited to the following: • ethical dilemmas; • safety / risk management; • resident care programs, with special consideration of the resident population language, culture, and care needs; • diagnostic services; • pharmacy and therapeutic; and • drug profiles and emergency on-call provision of care 3.4 Provide advice, when requested, to the Director of Homes and Seniors Services / Designate for the County on matters pertaining to medical care and services, including but not limited to the following: • organizing of medical services; • credentialing of physicians; • physician membership in appropriate associations; • continuing medical education; • annual review; and • arranging for medical care for residents without attending physicians. 3.5 Have the responsibility and authority to monitor and evaluate the medical care and services provided by physicians in the Home and to take action when expected to do so when standards are not met; 3.6 Be available to visit the Home at a minimum of once per week in order to carry out his or her responsibilities under this Medical Director Agreement; 3.7 Assist the Home with emergency medical services for residents in the event of disaster / evacuation; 3.8 Participate in quarterly Professional Advisory Committee (PAC); 3.9 Provide recommendations as requested on the Long -Term Care Home Quality Improvement Plan (LQIP) relative to the Home to the Continuous Quality Improvement Team; 3.10 Follow and adhere to all County policies and procedures including but not limited to the following: 53 • confidentiality; • code of conduct; • conflict of interest; and • all relative policies according to the legislative requirements for the Home. 3.11 Participate as requested in investigations, inquiries or hearings as may be required by the Administrator of the Home / Director of Homes and Seniors Services related to allegations of abuse, violations of the residents' bill of rights or professional misconduct. 4.0 The Medical Director shall when requested: 4.1 Participate in the review of Community Care Access Centre applications; 4.2 Participate in special care conferences related to resident issues that may put other residents, staff or visitors at risk; 4.3 Conduct an annual review of medical policies and make recommendations for improvement of same; 4.4 Provide medical liaison with local hospital(s) and other appropriate health care organizations or any long-term care home; 4.5 Participate in Infection and Control meetings and Continuous Quality Improvement (CQI) Meetings as requested, within the Home; 4.6 Co-operate with and/or be available during compliance reviews pertaining to medical issues, including inquiries made by the Ministry of Health and Long - Term Care Inspector, advocates, family members, and persons conduction coroner's investigations; and 4.7 Sign an Attending Physician's Agreement if the Medical Director is also an Attending Physician at the Home. 5.0 In the event that the Medical Director is temporarily unable to attend the Home at any time, the Medical Director shall so notify the Director of Homes and Seniors Services / Designate for the County of the name of his or her designate, if one is available, in advance of such unavailability. 6.0 The parties hereto acknowledge and agree that any research projects conducted at the Home will be permitted provided that such project meets approval of the Director of Homes and Seniors Services / Designate and is permitted by legislation. Publication or discussion of any research data collected from the Home must receive prior approval of the said Director. Any and all research projects undertaken at the Home must meet current ethical research and scientific standards. Furthermore, any research project must comply with the requirements of current privacy legislation. The Medical Director agrees to cooperate with and in any such research project as 54 approved by the Director of Homes and Seniors Services / Designate for conducting within the Home. 7.0 Except as provided for herein, this Agreement shall remain in force for a period of one (1) year from the date first written above. 8.0 This Agreement may be terminated by either party on at least one hundred and twenty (120) days written notice to the other; provided that, in the event of default in respect of any obligation hereunder, this agreement may be terminated on sixty (60) days written notice by the party not in default to the party in such default, within which sixty (60) day period the party in default shall have seven (7) days to end and/or remediate such default. 9.0 Notwithstanding that set forth in section 8.0 above, in the event that the Medical Director becomes unable to perform his duties for a period of one hundred twenty (120) consecutive days due to physical, psychological or mental illness or condition, the County may terminate this Agreement on thirty (30) days written notice to the Medical Director. 10.0 With the participation of the Medical Director, the Director of Homes and Seniors Services / Designate shall conduct an annual review to determine if the Medical Director is satisfying and complying with the terms and conditions of this Agreement and, if it is determined that the Medical Director is failing to satisfy and/or comply with such terms and conditions, the County shall be at liberty to terminate this Agreement pursuant to section 9.0 above. 11.0 In the event of death of the Medical Director, the within Agreement shall be deemed to be terminated as of date of such death. 12.0 In the event of termination of this Agreement as provided for above and in addition to any other entitlements provided for herein, the County shall pay to the Medical Director or his Estate, as the case may be, any and all amounts owing to and accruing to the benefit of the Medical Director up to and including the date of such termination. 13.0 This Agreement may be amended by written agreement signed by the parties and attached hereto, and such amendments shall be adhered to and have the same force as if they had originally formed part of this Agreement. 14.0 Any notice required by or contemplated under this Agreement shall be given in writing and shall be delivered personally as follows: (a) To the County at: (b) To the Medical Director: 450 Sunset Drive St. Thomas, ON N5R 5V1 1063 Talbot Street St. Thomas, ON N5P 1 G4 55 Each party may change its address for delivery under this Agreement by notice to the other party. 15.0 The Medical Director shall not assign his or her interest in this Agreement without first receiving the written consent of the County. 16.0 The parties hereto shall execute such further assurances as the other party shall reasonably be required to give effect to this Agreement. 17.0 This Agreement shall be binding upon and enure to the benefit of the parties hereto and their respective permitted successors. IN WITNESS WHEREOF the parties hereto have executed this Agreement under hand and seal at St. Thomas, Ontario this day of , 2018. Signed, Sealed, and Delivered In the Presence of Witness: Name: Services Per: Per: Per: Corporation of the County of Elgin Name: David Marr Position: Warden Name: Julie Gonyou Position: Chief Administrative Officer Name: Michele Harris Position: Director of Homes and Seniors We have the authority to bind the Corporation Per: 56 Derek Vaughan Name: Derek Vaughan Date: 2018 CORPORATION OF THE COUNTY OF ELGIN ME$ DEREK VAUGHAN Medical Director Agreement (Elgin Manor) Michele Harris Director of Homes and Seniors Services 450 Sunset Drive St. Thomas, ON N5R 5V1 57 MEDICAL DIRECTOR AGREEMENT THIS AGREEMENT made this day of , 2018. BETWEEN: /_LED CORPORATION OF THE COUNTY OF ELGIN (hereinafter referred to as the "County") MICHAEL TOTH (hereinafter referred to as the "Medical Director") WHEREAS the County desires to appoint a Medical Director for its long-term care home known as Terrace Lodge and situated in the Town of Aylmer, Ontario (hereinafter the "Home"); AND WHEREAS the Long -Term Care Homes Act, 2007 requires that there be a contract between the County and its Medical Director; AND WHEREAS the Medical Director wishes to enter into an Agreement with the County to perform the services described herein. NOW THEREFORE in consideration of the covenants and agreements hereinafter contained, the sufficiency of which is hereby acknowledged, the parties agree as follows: 1.0 The County shall: 1.1 Pay a fee to the Medical Director for the provision of professional services provided by the Medical Director, provided such fee is in accordance with the fee for such services as established by the Ministry of Health and Long -Term Care (MOHLTC) and provided further that any adjustments to this fee, as approved by the Ministry of Health and Long -Term Care, will be paid to the Medical Director immediately and/or retroactively to the effective date of such annual adjustments as approved by the Ministry of Health and Long -Term Care. 1.2 Provide the Medical Director with cellular telephone to provide on-call service to the Home and as agreed to by the Director of Homes and Seniors Services for the County. 1.3 Calculable in accordance with County policy in existence from time to time, pay mileage incurred for return travel from St. Thomas to Aylmer for the provision of services of Medical Director, 1.4 As currently available to non-union employees of the County of Elgin and revised from time to time, provide Extended Health Benefits, including dental, W semi -private hospital, deluxe travel, prescription drug, vision, hearing aid, and paramedical practitioner coverage, to the Medical Director and his eligible dependents; provided that the availability and specific extent of such coverage and benefits shall be subject to the terms and conditions and limitations applicable to same for non-union employees of the County. 1.5 Following the expiry of the term of this Agreement or any renewal thereof, the Medical Director may, at his own cost, convert any afore -mentioned health benefits available at the time of expiry of the term of this Agreement or any renewal thereof to an individual plan available to non -unionized employees of the County of Elgin but subject to any criteria then in effect at the instance of the carrier of such health benefits and options, noting that the general provisions for such health benefits currently in place provide, in part, as follows: "If your employment with the Employer terminates, you have the right to convert your coverage to an individual plan without providing Proof of Good Health. In addition, if one of your Dependents ceases to qualify as a Dependent under the Policy, he or she also has the right to convert coverage to an individual plan without providing Proof of Good Health. In order to apply for an individual plan of coverage, the person must submit a written application and the required premium to the insurer within 60 (sixty) days of the date the group coverage is terminated. The individual plan will be exchanged for all benefits on the person under this group benefit plan. The coverage under the individual plan will not duplicate the coverage under this group benefit plan and is subject to the terms and conditions of the individual plan being offered at that time." 1.6 Ensure that the County's liability insurance coverage for Directors of the Corporation shall be extended to the Medical Director as provided by the Insurance Carrier and adjusted from time to time. 1.7 Pay the Medical Director's fees (registration fees, accommodation costs, travel expenses, etc.) for continuing medical education and medical conferences to a yearly allocation of $2,000.00 in accordance with the County's convention attendance policy. 2.0 The County agrees to indemnify and save harmless the Medical Director from any claims, demands, damages or actions brought against the Medical Director in relation to the provision of service by employees of the Home who are not acting under the instructions of or under the direction of the Medical Director. 3.0 The Medical Director shall: 3.1 At all times be a medical doctor licensed by the College of Physicians and Surgeons of Ontario; 59 3.2 Obtain and maintain in full force and effect during the term of this Agreement, current, valid and adequate medical malpractice protection and insurance, and upon request, provide proof of such protection and insurance to the County; 3.3 Be accountable to the Director of Homes and Seniors Services / Designate for the County and, furthermore, be responsible for providing advice to the said Director on matters relating to medical care in the Home, including but not limited to the development, implementation, and evaluation of medical services in the Home and further including but not necessarily limited to the following: • ethical dilemmas; • safety / risk management; • resident care programs, with special consideration of the resident population language, culture, and care needs; • diagnostic services; • pharmacy and therapeutic; and • drug profiles and emergency on-call provision of care 3.4 Provide advice, when requested, to the Director of Homes and Seniors Services / Designate for the County on matters pertaining to medical care and services, including but not limited to the following: • organizing of medical services; • credentialing of physicians; • physician membership in appropriate associations; • continuing medical education; • annual review; and • arranging for medical care for residents without attending physicians. 3.5 Have the responsibility and authority to monitor and evaluate the medical care and services provided by physicians in the Home and to take action when expected to do so when standards are not met; 3.6 Be available to visit the Home at a minimum of once per week in order to carry out his or her responsibilities under this Medical Director Agreement; 3.7 Assist the Home with emergency medical services for residents in the event of disaster / evacuation; 3.8 Participate in quarterly Professional Advisory Committee (PAC); 3.9 Provide recommendations as requested on the Long -Term Care Home Quality Improvement Plan (LQIP) relative to the Home to the Continuous Quality Improvement Team; 3.10 Follow and adhere to all County policies and procedures including but not limited to the following: .E .0 • confidentiality; • code of conduct; • conflict of interest; and • all relative policies according to the legislative requirements for the Home. 3.11 Participate as requested in investigations, inquiries or hearings as may be required by the Administrator of the Home / Director of Homes and Seniors Services related to allegations of abuse, violations of the residents' bill of rights or professional misconduct. The Medical Director shall when requested: 4.1 Participate in the review of Community Care Access Centre applications; 4.2 Participate in special care conferences related to resident issues that may put other residents, staff or visitors at risk; 4.3 Conduct an annual review of medical policies and make recommendations for improvement of same; 4.4 Provide medical liaison with local hospital(s) and other appropriate health care organizations or any long-term care home; 4.5 Participate in Infection and Control meetings and Continuous Quality Improvement (CQI) Meetings as requested, within the Home; 4.6 Co-operate with and/or be available during compliance reviews pertaining to medical issues, including inquiries made by the Ministry of Health and Long - Term Care Inspector, advocates, family members, and persons conduction coroner's investigations; and 4.7 Sign an Attending Physician's Agreement if the Medical Director is also an Attending Physician at the Home. 5.0 In the event that the Medical Director is temporarily unable to attend the Home at any time, the Medical Director shall so notify the Director of Homes and Seniors Services / Designate for the County of the name of his or her designate, if one is available, in advance of such unavailability. 6.0 The parties hereto acknowledge and agree that any research projects conducted at the Home will be permitted provided that such project meets approval of the Director of Homes and Seniors Services / Designate and is permitted by legislation. Publication or discussion of any research data collected from the Home must receive prior approval of the said Director. Any and all research projects undertaken at the Home must meet current ethical research and scientific standards. Furthermore, any research project must comply with the requirements of current privacy legislation. The Medical Director agrees to cooperate with and in any such research project as 61 approved by the Director of Homes and Seniors Services / Designate for conducting within the Home. 7.0 Except as provided for herein, this Agreement shall remain in force for a period of one (1) year from the date first written above. 8.0 This Agreement may be terminated by either party on at least one hundred and twenty (120) days written notice to the other; provided that, in the event of default in respect of any obligation hereunder, this agreement may be terminated on sixty (60) days written notice by the party not in default to the party in such default, within which sixty (60) day period the party in default shall have seven (7) days to end and/or remediate such default. 9.0 Notwithstanding that set forth in section 8.0 above, in the event that the Medical Director becomes unable to perform his duties for a period of one hundred twenty (120) consecutive days due to physical, psychological or mental illness or condition, the County may terminate this Agreement on thirty (30) days written notice to the Medical Director. 10.0 With the participation of the Medical Director, the Director of Homes and Seniors Services / Designate shall conduct an annual review to determine if the Medical Director is satisfying and complying with the terms and conditions of this Agreement and, if it is determined that the Medical Director is failing to satisfy and/or comply with such terms and conditions, the County shall be at liberty to terminate this Agreement pursuant to section 9.0 above. 11.0 In the event of death of the Medical Director, the within Agreement shall be deemed to be terminated as of date of such death. 12.0 In the event of termination of this Agreement as provided for above and in addition to any other entitlements provided for herein, the County shall pay to the Medical Director or his Estate, as the case may be, any and all amounts owing to and accruing to the benefit of the Medical Director up to and including the date of such termination. 13.0 This Agreement may be amended by written agreement signed by the parties and attached hereto, and such amendments shall be adhered to and have the same force as if they had originally formed part of this Agreement. 14.0 Any notice required by or contemplated under this Agreement shall be given in writing and shall be delivered personally as follows: (a) To the County at: (b) To the Medical Director: 450 Sunset Drive St. Thomas, ON N5R 5V1 6 — 418 Talbot St. W. Aylmer, ON N5H 1 K9 W Each party may change its address for delivery under this Agreement by notice to the other party. 15.0 The Medical Director shall not assign his or her interest in this Agreement without first receiving the written consent of the County. 16.0 The parties hereto shall execute such further assurances as the other party shall reasonably be required to give effect to this Agreement. 17.0 This Agreement shall be binding upon and enure to the benefit of the parties hereto and their respective permitted successors. IN WITNESS WHEREOF the parties hereto have executed this Agreement under hand and seal at St. Thomas, Ontario this day of , 2018. Signed, Sealed, and Delivered In the Presence of Per: Per: 1= Corporation of the County of Elgin Name: David Marr Position: Warden Name: Julie Gonyou Position: Chief Administrative Officer Name: Michele Harris Position: Director of Homes and Seniors Services We have the authority to bind the Corporation Michael Toth Witness: ) Name: Per: Name: Michael Toth 63 Date: , 2018 CORPORATION OF THE COUNTY OF ELGIN w MICHAEL TOTH Medical Director Agreement (Terrace Lodge) Michele Harris Director of Homes and Seniors Services 450 Sunset Drive St. Thomas, ON N5R 5V1 yiu�wnnU111�� � IAgin! REPORT TO COUNTY COUNCIL FROM: Michele Harris, Director of Homes and Seniors Services DATE: June 18, 2018 SUBJECT: Attending Physician Agreements — Bobier Villa, Elgin Manor and Terrace Lodge INTRODUCTION: The Attending Physician agreement is a requirement of the Long -Term Care Homes Act, 2007 and Ontario Regulation 79/10 for the provision of medical services to the residents of Bobier Villa, Elgin Manor and Terrace Lodge. DISCUSSION: The Homes have the following attending physician agreements in place to provide medical services to the residents of the Homes: • Dr. Derek Vaughan — Bobier Villa and Elgin Manor • Dr. Michael Toth — Terrace Lodge • Dr. Ken Morrison — Elgin Manor • Dr. Edward Vivoda — Terrace Lodge CONCLUSION: Staff is recommending a one (1) year renewal agreement, with no revisions, for the attending physician agreements with Dr. Derek Vaughan, Dr. Michael Toth, Dr. Ken Morrison, and Dr. Edward Vivoda. RECOMMENDATIONS: THAT Council authorize staff to sign the one (1) year attending physician agreements from July 1, 2018 to June 30, 2019 with Dr. Derek Vaughan for the provision of medical services to residents of Bobier Villa and Elgin Manor; Dr. Michael Toth for Terrace Lodge; Dr. Ken Morrison for Elgin Manor; and Dr. Edward Vivoda for Terrace Lodge. All of which is Respectfully Submitted Approved for Submission Michele Harris Julie Gonyou Director of Homes and Seniors Services Chief Administrative Officer 65 ATTENDING PHYSICIAN AGREEMENT THIS AGREEMENT made this day of , 2018. BETWEEN: CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Bobier Villa (hereinafter referred to as the "Home") DEREK VAUGHAN (hereinafter referred to as the "Attending Physician") WHEREAS the Long -Term Care Homes Act, 2007 requires that there be a contract between a Home and its Attending Physicians; AND WHEREAS the Attending Physician wishes to enter into an Agreement with the Home to perform the services described below. NOW THEREFORE in consideration of the covenants and agreements hereinafter contained, the parties agree as follows: 1.0 Except as hereinafter provided, this agreement shall remain in place for a period of one (1) year from the date first written above and is subject to the termination provisions set out below. 2.0 The Home shall: 2.1 Make available to the Attending Physician copies of applicable legislation and policies; and 2.2 Provide the Attending Physician with access to the Home and cooperation from staff when carrying out the responsibilities listed below. 3.0 The Home agrees to indemnify and save harmless the Attending Physician from any claims, demands, damages or actions brought against the Attending Physician in relation to the provision of services by employees of the Home who are not acting under the instructions of or under the direction of the Attending Physician. 4.0 The Attending Physician: 4.1 Shall be a legally qualified medical practitioner licensed to practise medicine in Ontario; 4.2 Shall obtain and maintain in full force and effect during the term of this Agreement current and valid malpractice protection; 4.3 Shall be appointed by the Director of Homes and Seniors Services on the advice of the Medical Director; 4.4 Shall have hospital privileges in a local community hospital; 4.5 Shall be accountable to the Medical Director for meeting the Homes' policies, standards, and protocols of medical care, including those set out in Appendix "A", which is attached hereto and forms part of this Agreement; 4.6 Shall assess, plan, implement and evaluate the resident's medical care, develop a medical plan of treatment for the residents and participate in the interdisciplinary approach to care; 4.7 Shall document on the resident's health record upon admission and upon each subsequent visit, to maintain continuity and ongoing evaluation of all medical services as these relate to clinical diagnosis; 4.8 Shall endeavour in good faith to provide or make arrangements for reasonable on-call coverage for residents for whom he or she provides medical care; 4.9 Shall, when not personally available to take calls, advise the Home of emergency medical services which may be utilized; and 4.10 Shall be available to the Home an average of once per week in order to carry out his or her responsibilities under this Attending Physician Agreement. 5.0 The Attending Physician shall notify the Director of Homes and Seniors Services and Medical Director in the event that he or she is no longer available to care for a resident, so that alternative medical coverage can be arranged. 6.0 The Attending Physician agrees to indemnify and save harmless the Home from any claims, demands, damages or actions brought against it directly relating to the provision of physician services by the Attending Physician pursuant to this Agreement. 7.0 This Agreement may be terminated by either party on at least one hundred twenty (120) days written notice to the other; provided that in the event of default in respect of obligation hereunder, this agreement maybe terminated on thirty (30) days written notice by the party not in default to the party in such default, within which thirty (30) day period the party in default shall have seven (7) days to end and/or remediate such default. In the event that the Attending Physician becomes unable to perform his or her duties for a period of one hundred twenty (120) consecutive days due to physical, 67 psychological or mental illness or condition, the Home may terminate this Agreement on thirty (30) days written notice to the Attending Physician. In the event of death of the Attending Physician, the within Agreement shall be deemed to be terminated as of date of death. 8.0 This Agreement may be amended by written agreement signed by the parties and attached hereto, and such amendments shall be adhered to and have the same force as if they had originally formed part of this Agreement. IN WITNESS WHEREOF the parties have executed this Agreement, either personally or by hand of duly authorized officers, at St. Thomas, Ontario, this day of .2018. Signed, Sealed, and Delivered In the Presence of Witness: Name: Per: Per: Per: Corporation of the County of Elgin Name: David Marr Position: Warden Name: Julie Gonyou Position: Chief Administrative Officer Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation Derek Vaughan Per: Name: Derek Vaughan APPENDIX "A" (a) completing a written medical history and physical examination, within seven (7) days of the resident's admission to the Home; (b) providing medication, diet and treatment orders upon notification of the resident's admission and visiting the resident within seven (7) days of admission; (c) reviewing the resident's diet, medications, treatments, orders and update progress notes at least once every three (3) months; (d) visiting the resident as frequently as deemed necessary by the resident's health status and in accordance with the Home's policy and shall attend to any problems, write appropriate orders and/or progress notes at the time of the visit; (e) countersigning all verbal orders / directions within thirty (30) days; (f) completing and documenting an annual medical examination for each resident under his or her care; (g) complying with applicable provincial legislation; (h) providing an opportunity for the resident / substitute decision -maker to participate fully in the development and revision of the resident's medical care plan; (i) communicating with the resident, resident's family or substitute decision -maker as appropriate, and providing information to them regarding the resident's health status. Documentation on the progress notes of such communication shall be completed; (j) referring residents to the appropriate medical consultants and/or other health practitioners (ie physiotherapists, occupational therapists, social workers, speech therapists) when indicated; (k) where the physical or mental condition of a resident is such that the resident cannot properly be cared for in the Home, documenting such and attempting to arrange for the resident to be admitted to a general hospital or other facility best suited to provide the care required by the resident; (1) liaising with local hospital(s) to facilitate admission(s) and referrals to specialists; (m) making reasonable efforts to provide to residents under his or her care, the following: • participation at care conferences; • communication with family / substitute decision -maker; • completion of transfer forms; • telephone advice to Home's staff; and • completion of resident -specific Ministry of Health forms. (n) requisitioning diagnostic services as the resident's condition warrants; (o) following the Home's policies on documentation with special reference to the interdisciplinary approach, transfer information and discharge orders; (p) ensuring that all of his or her documentation is current, clear, legible, dated and signed; (q) participation in team discussions regarding advance directives with residents and/or families / substitute decision -makers; and (r) communicating with the Medical Director with respect to infection disease surveillance in the Home. 70 Between: M AMENDING AGREEMENT CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Bobier Villa (hereinafter referred to as the "Home") DEREK VAUGHAN (hereinafter referred to "Attending Physician") WHEREAS the Corporation of the County of Elgin and Derek Vaughan (the "Parties") entered into a contract (the "Contract") dated , 2018, for the purpose of amendment to Appendix "A" of the Attending Physician Agreement; AND WHEREAS the Parties desire to amend the Contract on the terms and conditions set forth in this Amending Agreement (the "Agreement"); AND WHEREAS this Agreement is the first amendment to the Contract. NOW THEREFORE in consideration of the Parties agreeing to amend their obligations in the existing Contract, and other valuable consideration, the receipt and sufficiency of what is hereby acknowledged, both Parties agree to keep, perform, and fulfill the promises, conditions and agreements below: 1.0 Amendment The Contract is amended as follows: a) The following provision is hereby added immediately to Appendix "A" of the Attending Physician Agreement after section "r)" of the Agreement: "The Attending Physician shall review and sign annually the Medical Directive for the administration of the Influenza Vaccine to the Homes' staff as delegated to the Homes' Registered Staff. The Home shall ensure that informed consent is given prior to the administration of the vaccine as per current Public Health Guidelines. The County shall annually review policies and procedures to ensure alignment with Public Health and Best Practice Guidelines". 71 IN WITNESS WHEREOF the Parties hereto have Attending Physician Agreement, as signed on personally or by hand of duly authorized officers at St of .2018. Signed, Sealed, and Delivered In the Presence of Witness: 71RIM, "I executed this addendum to the 2018 either Thomas, Ontario this day Corporation of the County of Elgin Per: Name: David Marr Position: Warden Per: Name: Julie Gonyou Position: Chief Administrative Officer Per: Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation 72 Derek Vaughan Name: Derek Vaughan Date: , 2018 CORPORATION OF THE COUNTY OF ELGIN BT49.4q ■�\ Attending Physician Agreement (Bobier Villa) Michele Harris Director of Homes and Seniors Services 450 Sunset Drive St. Thomas, ON N5R 5V1 73 ATTENDING PHYSICIAN AGREEMENT THIS AGREEMENT made this day of , 2018. BETWEEN: :►9 CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Elgin Manor (hereinafter referred to as the "Home") DEREK VAUGHAN (hereinafter referred to as the "Attending Physician") WHEREAS the Long -Term Care Homes Act, 2007 requires that there be a contract between a Home and its Attending Physicians; AND WHEREAS the Attending Physician wishes to enter into an Agreement with the Home to perform the services described below. NOW THEREFORE in consideration of the covenants and agreements hereinafter contained, the parties agree as follows: 1.0 Except as hereinafter provided, this agreement shall remain in place for a period of one (1) year from the date first written above and is subject to the termination provisions set out below. 2.0 The Home shall: 2.1 Make available to the Attending Physician copies of applicable legislation and policies; and 2.2 Provide the Attending Physician with access to the Home and cooperation from staff when carrying out the responsibilities listed below. 3.0 The Home agrees to indemnify and save harmless the Attending Physician from any claims, demands, damages or actions brought against the Attending Physician in relation to the provision of services by employees of the Home who are not acting under the instructions of or under the direction of the Attending Physician. 4.0 The Attending Physician: 4.1 Shall be a legally qualified medical practitioner licensed to practise medicine in Ontario; 74 4.2 Shall obtain and maintain in full force and effect during the term of this Agreement current and valid malpractice protection; 4.3 Shall be appointed by the Director of Homes and Seniors Services on the advice of the Medical Director; 4.4 Shall have hospital privileges in a local community hospital; 4.5 Shall be accountable to the Medical Director for meeting the Homes' policies, standards, and protocols of medical care, including those set out in Appendix "A", which is attached hereto and forms part of this Agreement; 4.6 Shall assess, plan, implement and evaluate the resident's medical care, develop a medical plan of treatment for the residents and participate in the interdisciplinary approach to care; 4.7 Shall document on the resident's health record upon admission and upon each subsequent visit, to maintain continuity and ongoing evaluation of all medical services as these relate to clinical diagnosis; 4.8 Shall endeavour in good faith to provide or make arrangements for reasonable on-call coverage for residents for whom he or she provides medical care; 4.9 Shall, when not personally available to take calls, advise the Home of emergency medical services which may be utilized; and 4.10 Shall be available to the Home an average of once per week in order to carry out his or her responsibilities under this Attending Physician Agreement. 5.0 The Attending Physician shall notify the Director of Homes and Seniors Services and Medical Director in the event that he or she is no longer available to care for a resident, so that alternative medical coverage can be arranged. 6.0 The Attending Physician agrees to indemnify and save harmless the Home from any claims, demands, damages or actions brought against it directly relating to the provision of physician services by the Attending Physician pursuant to this Agreement. 7.0 This Agreement may be terminated by either party on at least one hundred twenty (120) days written notice to the other; provided that in the event of default in respect of obligation hereunder, this agreement maybe terminated on thirty (30) days written notice by the party not in default to the party in such default, within which thirty (30) day period the party in default shall have seven (7) days to end and/or remediate such default. In the event that the Attending Physician becomes unable to perform his or her duties for a period of one hundred twenty (120) consecutive days due to physical, 75 psychological or mental illness or condition, the Home may terminate this Agreement on thirty (30) days written notice to the Attending Physician. In the event of death of the Attending Physician, the within Agreement shall be deemed to be terminated as of date of death. 8.0 This Agreement may be amended by written agreement signed by the parties and attached hereto, and such amendments shall be adhered to and have the same force as if they had originally formed part of this Agreement. IN WITNESS WHEREOF the parties have executed this Agreement, either personally or by hand of duly authorized officers, at St. Thomas, Ontario, this day of .2018. Signed, Sealed, and Delivered In the Presence of Witness: Corporation of the County of Elgin Per: Name: David Marr Position: Warden Per: Per: Name: Julie Gonyou Position: Chief Administrative Officer Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation Name: ) Per: 76 Derek Vaughan Name: Derek Vaughan APPENDIX "A" (a) completing a written medical history and physical examination, within seven (7) days of the resident's admission to the Home; (b) providing medication, diet and treatment orders upon notification of the resident's admission and visiting the resident within seven (7) days of admission; (c) reviewing the resident's diet, medications, treatments, orders and update progress notes at least once every three (3) months; (d) visiting the resident as frequently as deemed necessary by the resident's health status and in accordance with the Home's policy and shall attend to any problems, write appropriate orders and/or progress notes at the time of the visit; (e) countersigning all verbal orders / directions within thirty (30) days; (f) completing and documenting an annual medical examination for each resident under his or her care; (g) complying with applicable provincial legislation; (h) providing an opportunity for the resident / substitute decision -maker to participate fully in the development and revision of the resident's medical care plan; (i) communicating with the resident, resident's family or substitute decision -maker as appropriate, and providing information to them regarding the resident's health status. Documentation on the progress notes of such communication shall be completed; (j) referring residents to the appropriate medical consultants and/or other health practitioners (ie physiotherapists, occupational therapists, social workers, speech therapists) when indicated; (k) where the physical or mental condition of a resident is such that the resident cannot properly be cared for in the Home, documenting such and attempting to arrange for the resident to be admitted to a general hospital or other facility best suited to provide the care required by the resident; (1) liaising with local hospital(s) to facilitate admission(s) and referrals to specialists; (m) making reasonable efforts to provide to residents under his or her care, the following: • participation at care conferences; • communication with family / substitute decision -maker; • completion of transfer forms; • telephone advice to Home's staff; and • completion of resident -specific Ministry of Health forms. 77 (n) requisitioning diagnostic services as the resident's condition warrants; (o) following the Home's policies on documentation with special reference to the interdisciplinary approach, transfer information and discharge orders; (p) ensuring that all of his or her documentation is current, clear, legible, dated and signed; (q) participation in team discussions regarding advance directives with residents and/or families / substitute decision -makers; and (r) communicating with the Medical Director with respect to infection disease surveillance in the Home. W Between: :►q '►1__►it] ► RVITC1 :___11_► 1 CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Elgin Manor (hereinafter referred to as the "Home") DEREK VAUGHAN (hereinafter referred to "Attending Physician") WHEREAS the Corporation of the County of Elgin and Derek Vaughan (the "Parties") entered into a contract (the "Contract") dated , 2018, for the purpose of amendment to Appendix "A" of the Attending Physician Agreement; AND WHEREAS the Parties desire to amend the Contract on the terms and conditions set forth in this Amending Agreement (the "Agreement"); AND WHEREAS this Agreement is the first amendment to the Contract. NOW THEREFORE in consideration of the Parties agreeing to amend their obligations in the existing Contract, and other valuable consideration, the receipt and sufficiency of what is hereby acknowledged, both Parties agree to keep, perform, and fulfill the promises, conditions and agreements below: 1.0 Amendment The Contract is amended as follows: a) The following provision is hereby added immediately to Appendix "A" of the Attending Physician Agreement after section "r)" of the Agreement: "The Attending Physician shall review and sign annually the Medical Directive for the administration of the Influenza Vaccine to the Homes' staff as delegated to the Homes' Registered Staff. The Home shall ensure that informed consent is given prior to the administration of the vaccine as per current Public Health Guidelines. The County shall annually review policies and procedures to ensure alignment with Public Health and Best Practice Guidelines': 79 IN WITNESS WHEREOF the Parties hereto have executed this addendum to the Attending Physician Agreement, as signed on , 2018 either personally or by hand of duly authorized officers at St. Thomas, Ontario this day of , 2018. Signed, Sealed, and Delivered In the Presence of Witness: Corporation of the County of Elgin Per: Name: David Marr Position: Warden Per: Per: Name: Julie Gonyou Position: Chief Administrative Officer Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation Name: ) Per: 0 Derek Vaughan Name: Derek Vaughan Date: 2018 CORPORATION OF THE COUNTY OF ELGIN rare DEREK VAUGHAN Attending Physician Agreement (Elgin Manor) Michele Harris Director of Homes and Seniors Services 450 Sunset Drive St. Thomas, ON N5R 5V1 a ATTENDING PHYSICIAN AGREEMENT THIS AGREEMENT made this day of , 2018. -1:41TiTI:11A CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Terrace Lodge (hereinafter referred to as the "Home") MICHAEL TOTH (hereinafter referred to as the "Attending Physician") WHEREAS the Long -Term Care Homes Act, 2007 requires that there be a contract between a Home and its Attending Physicians; AND WHEREAS the Attending Physician wishes to enter into an Agreement with the Home to perform the services described below. NOW THEREFORE in consideration of the covenants and agreements hereinafter contained, the parties agree as follows: 1.0 Except as hereinafter provided, this agreement shall remain in place for a period of one (1) year from the date first written above and is subject to the termination provisions set out below. 2.0 The Home shall: 2.1 Make available to the Attending Physician copies of applicable legislation and policies; and 2.2 Provide the Attending Physician with access to the Home and cooperation from staff when carrying out the responsibilities listed below. 3.0 The Home agrees to indemnify and save harmless the Attending Physician from any claims, demands, damages or actions brought against the Attending Physician in relation to the provision of services by employees of the Home who are not acting under the instructions of or under the direction of the Attending Physician. 4.0 The Attending Physician: 4.1 Shall be a legally qualified medical practitioner licensed to practise medicine in Ontario; W, 4.2 Shall obtain and maintain in full force and effect during the term of this Agreement current and valid malpractice protection; 4.3 Shall be appointed by the Director of Homes and Seniors Services on the advice of the Medical Director; 4.4 Shall have hospital privileges in a local community hospital; 4.5 Shall be accountable to the Medical Director for meeting the Homes' policies, standards, and protocols of medical care, including those set out in Appendix "A", which is attached hereto and forms part of this Agreement; 4.6 Shall assess, plan, implement and evaluate the resident's medical care, develop a medical plan of treatment for the residents and participate in the interdisciplinary approach to care; 4.7 Shall document on the resident's health record upon admission and upon each subsequent visit, to maintain continuity and ongoing evaluation of all medical services as these relate to clinical diagnosis; 4.8 Shall endeavour in good faith to provide or make arrangements for reasonable on-call coverage for residents for whom he or she provides medical care; 4.9 Shall, when not personally available to take calls, advise the Home of emergency medical services which maybe utilized; and 4.10 Shall be available to the Home an average of once per week in order to carry out his or her responsibilities under this Attending Physician Agreement. 5.0 The Attending Physician shall notify the Director of Homes and Seniors Services and Medical Director in the event that he or she is no longer available to care for a resident, so that alternative medical coverage can be arranged. 6.0 The Attending Physician agrees to indemnify and save harmless the Home from any claims, demands, damages or actions brought against it directly relating to the provision of physician services by the Attending Physician pursuant to this Agreement. 7.0 This Agreement may be terminated by either party on at least one hundred twenty (120) days written notice to the other; provided that in the event of default in respect of obligation hereunder, this agreement maybe terminated on thirty (30) days written notice by the party not in default to the party in such default, within which thirty (30) day period the party in default shall have seven (7) days to end and/or remediate such default. In the event that the Attending Physician becomes unable to perform his or her duties for a period of one hundred twenty (120) consecutive days due to physical, W psychological or mental illness or condition, the Home may terminate this Agreement on thirty (30) days written notice to the Attending Physician. In the event of death of the Attending Physician, the within Agreement shall be deemed to be terminated as of date of death. 8.0 This Agreement may be amended by written agreement signed by the parties and attached hereto, and such amendments shall be adhered to and have the same force as if they had originally formed part of this Agreement. IN WITNESS WHEREOF the parties have executed this Agreement, either personally or by hand of duly authorized officers, at St. Thomas, Ontario, this day of , 2018. Signed, Sealed, and Delivered In the Presence of Witness: Name: Corporation of the County of Elgin Per: Name: David Marr Position: Warden Per: Name: Julie Gonyou Position: Chief Administrative Officer Per: Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation Michael Toth Per: Name: Michael Toth 01 APPENDIX "A" (a) completing a written medical history and physical examination, within seven (7) days of the resident's admission to the Home; (b) providing medication, diet and treatment orders upon notification of the resident's admission and visiting the resident within seven (7) days of admission; (c) reviewing the resident's diet, medications, treatments, orders and update progress notes at least once every three (3) months; (d) visiting the resident as frequently as deemed necessary by the resident's health status and in accordance with the Home's policy and shall attend to any problems, write appropriate orders and/or progress notes at the time of the visit; (e) countersigning all verbal orders / directions within thirty (30) days; (f) completing and documenting an annual medical examination for each resident under his or her care; (g) complying with applicable provincial legislation; (h) providing an opportunity for the resident / substitute decision -maker to participate fully in the development and revision of the resident's medical care plan; (i) communicating with the resident, resident's family or substitute decision -maker as appropriate, and providing information to them regarding the resident's health status. Documentation on the progress notes of such communication shall be completed; Q) referring residents to the appropriate medical consultants and/or other health practitioners (ie physiotherapists, occupational therapists, social workers, speech therapists) when indicated; (k) where the physical or mental condition of a resident is such that the resident cannot properly be cared for in the Home, documenting such and attempting to arrange for the resident to be admitted to a general hospital or other facility best suited to provide the care required by the resident; (1) liaising with local hospital(s) to facilitate admission(s) and referrals to specialists; (m) making reasonable efforts to provide to residents under his or her care, the following: • participation at care conferences; • communication with family / substitute decision -maker; • completion of transfer forms; • telephone advice to Home's staff; and • completion of resident -specific Ministry of Health forms. 99 (n) requisitioning diagnostic services as the resident's condition warrants; (o) following the Home's policies on documentation with special reference to the interdisciplinary approach, transfer information and discharge orders; (p) ensuring that all of his or her documentation is current, clear, legible, dated and signed; (q) participation in team discussions regarding advance directives with residents and/or families / substitute decision -makers; and (r) communicating with the Medical Director with respect to infection disease surveillance in the Home. Between: M AMENDING AGREEMENT CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Terrace Lodge (hereinafter referred to as the "Home") MICHAEL TOTH (hereinafter referred to "Attending Physician") WHEREAS the Corporation of the County of Elgin and Michael Toth (the "Parties") entered into a contract (the "Contract") dated , 2018, for the purpose of amendment to Appendix "A" of the Attending Physician Agreement; AND WHEREAS the Parties desire to amend the Contract on the terms and conditions set forth in this Amending Agreement (the "Agreement"); AND WHEREAS this Agreement is the first amendment to the Contract. NOW THEREFORE in consideration of the Parties agreeing to amend their obligations in the existing Contract, and other valuable consideration, the receipt and sufficiency of what is hereby acknowledged, both Parties agree to keep, perform, and fulfill the promises, conditions and agreements below: 1.0 Amendment The Contract is amended as follows: a) The following provision is hereby added immediately to Appendix "A" of the Attending Physician Agreement after section "r)" of the Agreement: "The Attending Physician shall review and sign annually the Medical Directive for the administration of the Influenza Vaccine to the Homes' staff as delegated to the Homes' Registered Staff. The Home shall ensure that informed consent is given prior to the administration of the vaccine as per current Public Health Guidelines. The County shall annually review policies and procedures to ensure alignment with Public Health and Best Practice Guidelines". M IN WITNESS WHEREOF the Parties hereto have executed this addendum to the Attending Physician Agreement, as signed on , 2018 either personally or by hand of duly authorized officers at St. Thomas, Ontario this day of , 2018. Signed, Sealed, and Delivered In the Presence of Witness: Name: ZM Per: Per: Corporation of the County of Elgin Name: David Marr Position: Warden Name: Julie Gonyou Position: Chief Administrative Officer Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation Michael Toth Per: Name: Michael Toth Date: 2018 CORPORATION OF THE COUNTY OF ELGIN and MICHAEL TOTH Attending Physician Agreement (Terrace Lodge) Michele Harris Director of Homes and Seniors Services 450 Sunset Drive St. Thomas, ON N5R 5V1 ATTENDING PHYSICIAN AGREEMENT THIS AGREEMENT made this day of , 2018. .. 1 ► &HUB CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Elgin Manor (hereinafter referred to as the "Home") KEN MORRISON (hereinafter referred to as the "Attending Physician") WHEREAS the Long -Term Care Homes Act, 2007 requires that there be a contract between a Home and its Attending Physicians; AND WHEREAS the Attending Physician wishes to enter into an Agreement with the Home to perform the services described below. NOW THEREFORE in consideration of the covenants and agreements hereinafter contained, the parties agree as follows: 1.0 Except as hereinafter provided, this agreement shall remain in place for a period of one (1) year from the date first written above and is subject to the termination provisions set out below. 2.0 The Home shall: 2.1 Make available to the Attending Physician copies of applicable legislation and policies; and 2.2 Provide the Attending Physician with access to the Home and cooperation from staff when carrying out the responsibilities listed below. 3.0 The Home agrees to indemnify and save harmless the Attending Physician from any claims, demands, damages or actions brought against the Attending Physician in relation to the provision of services by employees of the Home who are not acting under the instructions of or under the direction of the Attending Physician. 4.0 The Attending Physician: 4.1 Shall be a legally qualified medical practitioner licensed to practise medicine in Ontario; a 4.2 Shall obtain and maintain in full force and effect during the term of this Agreement current and valid malpractice protection; 4.3 Shall be appointed by the Director of Homes and Seniors Services on the advice of the Medical Director; 4.4 Shall have hospital privileges in a local community hospital; 4.5 Shall be accountable to the Medical Director for meeting the Homes' policies, standards, and protocols of medical care, including those set out in Appendix "A", which is attached hereto and forms part of this Agreement; 4.6 Shall assess, plan, implement and evaluate the resident's medical care, develop a medical plan of treatment for the residents and participate in the interdisciplinary approach to care; 4.7 Shall document on the resident's health record upon admission and upon each subsequent visit, to maintain continuity and ongoing evaluation of all medical services as these relate to clinical diagnosis; 4.8 Shall endeavour in good faith to provide or make arrangements for reasonable on-call coverage for residents for whom he or she provides medical care; 4.9 Shall, when not personally available to take calls, advise the Home of emergency medical services which may be utilized; and 4.10 Shall be available to the Home an average of once per week in order to carry out his or her responsibilities under this Attending Physician Agreement. 5.0 The Attending Physician shall notify the Director of Homes and Seniors Services and Medical Director in the event that he or she is no longer available to care for a resident, so that alternative medical coverage can be arranged. 6.0 The Attending Physician agrees to indemnify and save harmless the Home from any claims, demands, damages or actions brought against it directly relating to the provision of physician services by the Attending Physician pursuant to this Agreement. 7.0 This Agreement may be terminated by either party on at least one hundred twenty (120) days written notice to the other; provided that in the event of default in respect of obligation hereunder, this agreement maybe terminated on thirty (30) days written notice by the party not in default to the party in such default, within which thirty (30) day period the party in default shall have seven (7) days to end and/or remediate such default. In the event that the Attending Physician becomes unable to perform his or her duties for a period of one hundred twenty (120) consecutive days due to physical, 91 psychological or mental illness or condition, the Home may terminate this Agreement on thirty (30) days written notice to the Attending Physician. In the event of death of the Attending Physician, the within Agreement shall be deemed to be terminated as of date of death. 8.0 This Agreement may be amended by written agreement signed by the parties and attached hereto, and such amendments shall be adhered to and have the same force as if they had originally formed part of this Agreement. IN WITNESS WHEREOF the parties have executed this Agreement, either personally or by hand of duly authorized officers, at St. Thomas, Ontario, this day of , 2018. Signed, Sealed, and Delivered In the Presence of Witness: Name: Per: Per: Per: Corporation of the County of Elgin Name: David Marr Position: Warden Name: Julie Gonyou Position: Chief Administrative Officer Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation Per: 'y, Ken Morrison Name: Ken Morrison APPENDIX "A" (a) completing a written medical history and physical examination, within seven (7) days of the resident's admission to the Home; (b) providing medication, diet and treatment orders upon notification of the resident's admission and visiting the resident within seven (7) days of admission; (c) reviewing the resident's diet, medications, treatments, orders and update progress notes at least once every three (3) months; (d) visiting the resident as frequently as deemed necessary by the resident's health status and in accordance with the Home's policy and shall attend to any problems, write appropriate orders and/or progress notes at the time of the visit; (e) countersigning all verbal orders / directions within thirty (30) days; (f) completing and documenting an annual medical examination for each resident under his or her care; (g) complying with applicable provincial legislation; (h) providing an opportunity for the resident / substitute decision -maker to participate fully in the development and revision of the resident's medical care plan; (i) communicating with the resident, resident's family or substitute decision -maker as appropriate, and providing information to them regarding the resident's health status. Documentation on the progress notes of such communication shall be completed; (j) referring residents to the appropriate medical consultants and/or other health practitioners (ie physiotherapists, occupational therapists, social workers, speech therapists) when indicated; (k) where the physical or mental condition of a resident is such that the resident cannot properly be cared for in the Home, documenting such and attempting to arrange for the resident to be admitted to a general hospital or other facility best suited to provide the care required by the resident; (1) liaising with local hospital(s) to facilitate admission(s) and referrals to specialists; (m) making reasonable efforts to provide to residents under his or her care, the following: • participation at care conferences; • communication with family / substitute decision -maker; • completion of transfer forms; • telephone advice to Home's staff; and • completion of resident -specific Ministry of Health forms. 93 (n) requisitioning diagnostic services as the resident's condition warrants; (o) following the Home's policies on documentation with special reference to the interdisciplinary approach, transfer information and discharge orders; (p) ensuring that all of his or her documentation is current, clear, legible, dated and signed; (q) participation in team discussions regarding advance directives with residents and/or families / substitute decision -makers; and (r) communicating with the Medical Director with respect to infection disease surveillance in the Home. Between: N AMENDING AGREEMENT CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Elgin Manor (hereinafter referred to as the "Home") KEN MORRISON (hereinafter referred to "Attending Physician") WHEREAS the Corporation of the County of Elgin and Ken Morrison (the "Parties") entered into a contract (the "Contract") dated , 2018, for the purpose of amendment to Appendix "A" of the Attending Physician Agreement; AND WHEREAS the Parties desire to amend the Contract on the terms and conditions set forth in this Amending Agreement (the "Agreement"); AND WHEREAS this Agreement is the first amendment to the Contract. NOW THEREFORE in consideration of the Parties agreeing to amend their obligations in the existing Contract, and other valuable consideration, the receipt and sufficiency of what is hereby acknowledged, both Parties agree to keep, perform, and fulfill the promises, conditions and agreements below: 1.0 Amendment The Contract is amended as follows: a) The following provision is hereby added immediately to Appendix "A" of the Attending Physician Agreement after section "r)" of the Agreement: "The Attending Physician shall review and sign annually the Medical Directive for the administration of the Influenza Vaccine to the Homes' staff as delegated to the Homes' Registered Staff. The Home shall ensure that informed consent is given prior to the administration of the vaccine as per current Public Health Guidelines. The County shall annually review policies and procedures to ensure alignment with Public Health and Best Practice Guidelines". 95 IN WITNESS WHEREOF the Parties hereto have executed this addendum to the Attending Physician Agreement, as signed on , 2018 either personally or by hand of duly authorized officers at St. Thomas, Ontario this day of , 2018. Signed, Sealed, and Delivered In the Presence of Witness: Name: Corporation of the County of Elgin Per: Name: David Marr Position: Warden Per: Name: Julie Gonyou Position: Chief Administrative Officer Per: Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation Ken Morrison Per: Name: Ken Morrison Date: , 2018 CORPORATION OF THE COUNTY OF ELGIN and KEN MORRISON Attending Physician Agreement (Elgin Manor) Michele Harris Director of Homes and Seniors Services 450 Sunset Drive St. Thomas, ON N5R 5V1 97 :►9 ATTENDING PHYSICIAN AGREEMENT THIS AGREEMENT made this day of , 2018. 1_-► CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Terrace Lodge (hereinafter referred to as the "Home") EDWARD VIVODA (hereinafter referred to as the "Attending Physician") WHEREAS the Long -Term Care Homes Act, 2007 requires that there be a contract between a Home and its Attending Physicians; AND WHEREAS the Attending Physician wishes to enter into an Agreement with the Home to perform the services described below. NOW THEREFORE in consideration of the covenants and agreements hereinafter contained, the parties agree as follows: 1.0 Except as hereinafter provided, this agreement shall remain in place for a period of one (1) year from the date first written above and is subject to the termination provisions set out below. 2.0 The Home shall: 2.1 Make available to the Attending Physician copies of applicable legislation and policies; and 2.2 Provide the Attending Physician with access to the Home and cooperation from staff when carrying out the responsibilities listed below. 3.0 The Home agrees to indemnify and save harmless the Attending Physician from any claims, demands, damages or actions brought against the Attending Physician in relation to the provision of services by employees of the Home who are not acting under the instructions of or under the direction of the Attending Physician. 4.0 The Attending Physician: 4.1 Shall be a legally qualified medical practitioner licensed to practise medicine in Ontario; 4.2 Shall obtain and maintain in full force and effect during the term of this Agreement current and valid malpractice protection; 4.3 Shall be appointed by the Director of Homes and Seniors Services on the advice of the Medical Director; 4.4 Shall have hospital privileges in a local community hospital; 4.5 Shall be accountable to the Medical Director for meeting the Homes' policies, standards, and protocols of medical care, including those set out in Appendix "A", which is attached hereto and forms part of this Agreement; 4.6 Shall assess, plan, implement and evaluate the resident's medical care, develop a medical plan of treatment for the residents and participate in the interdisciplinary approach to care; 4.7 Shall document on the resident's health record upon admission and upon each subsequent visit, to maintain continuity and ongoing evaluation of all medical services as these relate to clinical diagnosis; 4.8 Shall endeavour in good faith to provide or make arrangements for reasonable on-call coverage for residents for whom he or she provides medical care; 4.9 Shall, when not personally available to take calls, advise the Home of emergency medical services which may be utilized; and 4.10 Shall be available to the Home an average of once per week in order to carry out his or her responsibilities under this Attending Physician Agreement. 5.0 The Attending Physician shall notify the Director of Homes and Seniors Services and Medical Director in the event that he or she is no longer available to care for a resident, so that alternative medical coverage can be arranged. 6.0 The Attending Physician agrees to indemnify and save harmless the Home from any claims, demands, damages or actions brought against it directly relating to the provision of physician services by the Attending Physician pursuant to this Agreement. 7.0 This Agreement may be terminated by either party on at least one hundred twenty (120) days written notice to the other; provided that in the event of default in respect of obligation hereunder, this agreement maybe terminated on thirty (30) days written notice by the party not in default to the party in such default, within which thirty (30) day period the party in default shall have seven (7) days to end and/or remediate such default. In the event that the Attending Physician becomes unable to perform his or her duties for a period of one hundred twenty (120) consecutive days due to physical, 99 psychological or mental illness or condition, the Home may terminate this Agreement on thirty (30) days written notice to the Attending Physician. In the event of death of the Attending Physician, the within Agreement shall be deemed to be terminated as of date of death. 8.0 This Agreement may be amended by written agreement signed by the parties and attached hereto, and such amendments shall be adhered to and have the same force as if they had originally formed part of this Agreement. IN WITNESS WHEREOF the parties have executed this Agreement, either personally or by hand of duly authorized officers, at St. Thomas, Ontario, this day of , 2018. Signed, Sealed, and Delivered In the Presence of Witness: Per: Per: Corporation of the County of Elgin Name: David Marr Position: Warden Name: Julie Gonyou Position: Chief Administrative Officer Per: Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation Name: ) Per: 100 Edward Vivoda Name: Edward Vivoda APPENDIX "A" (a) completing a written medical history and physical examination, within seven (7) days of the resident's admission to the Home; (b) providing medication, diet and treatment orders upon notification of the resident's admission and visiting the resident within seven (7) days of admission; (c) reviewing the resident's diet, medications, treatments, orders and update progress notes at least once every three (3) months; (d) visiting the resident as frequently as deemed necessary by the resident's health status and in accordance with the Home's policy and shall attend to any problems, write appropriate orders and/or progress notes at the time of the visit; (e) countersigning all verbal orders / directions within thirty (30) days; (f) completing and documenting an annual medical examination for each resident under his or her care; (g) complying with applicable provincial legislation; (h) providing an opportunity for the resident / substitute decision -maker to participate fully in the development and revision of the resident's medical care plan; (i) communicating with the resident, resident's family or substitute decision -maker as appropriate, and providing information to them regarding the resident's health status. Documentation on the progress notes of such communication shall be completed; (j) referring residents to the appropriate medical consultants and/or other health practitioners (ie physiotherapists, occupational therapists, social workers, speech therapists) when indicated; (k) where the physical or mental condition of a resident is such that the resident cannot properly be cared for in the Home, documenting such and attempting to arrange for the resident to be admitted to a general hospital or other facility best suited to provide the care required by the resident; (1) liaising with local hospital(s) to facilitate admission(s) and referrals to specialists; (m) making reasonable efforts to provide to residents under his or her care, the following: • participation at care -conferences; • communication with family / substitute decision -maker; • completion of transfer forms; • telephone advice to Home's staff; and • completion of resident -specific Ministry of Health forms. 101 (n) requisitioning diagnostic services as the resident's condition warrants; (o) following the Home's policies on documentation with special reference to the interdisciplinary approach, transfer information and discharge orders; (p) ensuring that all of his or her documentation is current, clear, legible, dated and signed; (q) participation in team discussions regarding advance directives with residents and/or families / substitute decision -makers; and (r) communicating with the Medical Director with respect to infection disease surveillance in the Home. 102 Between: MSB AMENDING AGREEMENT CORPORATION OF THE COUNTY OF ELGIN A municipal body operating a Home for the Aged known as Terrace Lodge (hereinafter referred to as the "Home") EDWARD VIVODA (hereinafter referred to "Attending Physician") WHEREAS the Corporation of the County of Elgin and Edward Vivoda (the "Parties") entered into a contract (the "Contract") dated , 2018, for the purpose of amendment to Appendix "A" of the Attending Physician Agreement; AND WHEREAS the Parties desire to amend the Contract on the terms and conditions set forth in this Amending Agreement (the "Agreement"); AND WHEREAS this Agreement is the first amendment to the Contract. NOW THEREFORE in consideration of the Parties agreeing to amend their obligations in the existing Contract, and other valuable consideration, the receipt and sufficiency of what is hereby acknowledged, both Parties agree to keep, perform, and fulfill the promises, conditions and agreements below: 1.0 Amendment The Contract is amended as follows: a) The following provision is hereby added immediately to Appendix "A" of the Attending Physician Agreement after section "r)" of the Agreement: "The Attending Physician shall review and sign annually the Medical Directive for the administration of the Influenza Vaccine to the Homes' staff as delegated to the Homes' Registered Staff. The Home shall ensure that informed consent is given prior to the administration of the vaccine as per current Public Health Guidelines. The County shall annually review policies and procedures to ensure alignment with Public Health and Best Practice Guidelines". 103 IN WITNESS WHEREOF the Parties hereto have executed this addendum to the Attending Physician Agreement, as signed on , 2018 either personally or by hand of duly authorized officers at St. Thomas, Ontario this day of , 2018. Signed, Sealed, and Delivered In the Presence of Witness: Name: Corporation of the County of Elgin Per: Name: David Marr Position: Warden Per: Per: Name: Julie Gonyou Position: Chief Administrative Officer Name: Michele Harris Position: Director of Homes & Seniors Services We have the authority to bind the Corporation Edward Vivoda Per: Name: Edward Vivoda 104 Date: 2018 CORPORATION OF THE COUNTY OF ELGIN and EDWARD VIVODA Attending Physician Agreement (Terrace Lodge) Michele Harris Director of Homes and Seniors Services 450 Sunset Drive St. Thomas, ON N5R 5V1 105 CORRESPONDENCE — June 26, 2018 Item for Information (Consent Agenda) — (Attached) Thames Valley Family Health Team 2017-2018 Community Report 106 . A% 0 COMMUNITY REPOR""r CELEBRATING 10 YEARS OF COLLABORATION 107 EBRATING We can't highlight in detail all of the valuable CEL activities being undertaken atTVFHT — some are just being launched and we are excited to measure the outcomes. A sampling of these include: OUR SUCCESS ND LOOKING /f �"`i a HE FUTU RE 2017 has been a year of celebration for the Thames Valley Family Health Team (TVFHT). We have spent time reflecting on the successes of the past 10 years, and looking forward to future collaboration and innovation to support the health and wellbeing of the people of Thames Valley. Putting the first year of our 2017-2020 strategic plan into action was an important part of moving TVFHT forward. We continued to work internally, and with partners, in implementing important initiatives that support the advancement of our Quality Improvement Plan targets for 2018/19. In this report, we are pleased to share examples of initiatives that have furthered our ability to provide high-quality, team - based collaborative care. Online centralized registration for most of our group programs — this is in response to patient and staff feedback and will enhance access. Partnership with the Centre for Effective Practice to engage our pharmacists in an Academic Detailing program — this valuable training allows them to implement a proven method of supporting up-to-date, evidence -based practice and information sharing. Involvement in community health promotion activities — our Nurse Practitioners championed participation in Cervical Cancer Awareness Week, resulting in 131 screening tests occurring in a one-week blitz. Education and networking—TVFHT's Occupational Therapists were thrilled to host the 2018 provincial Primary Care Occupational Therapy Day. Implementing best practice — our Respiratory Therapists are exploring the Chronic Obstructive Pulmonary Disease (COPD) model designed in the Erie -St. Clair region and determining which components would add value to our current program. As you read about the activities detailed in this report, you will understand why we are so proud of our dedicated, skilled and compassionate employees, partnering physicians, board members, and community partners. ursuccess is wholly thanks tOYOLI. Please take a moment to read our report and savour the successes with us — you have been an important part of them! March 2007 March 2011 October 2015 Received articles Reached 100,000 Reached 500,000 of incorporation patient visits patient visits September 2007 February 2014 2020 First employee hired 100th employee hired Projected to reach 1 Million patient visits! m 2 MILLION CANADIANS OVER BV%OFALL FRACTURES are affected by osteoporosis in people 50+ are caused by osteoporosis Nurse practitioners Melissa HmJnr,Courtney Rocca and Elizabeth Smith from TVFHT'sOld South site recently put the family health team philosophy ofpreventative care into practice. They found that preventative testing sometimes gets missed ifthe patient doesn't see their healthcare provider regularly. Along with physician partners and with support from Osteoporosis Canada, they decided tofocus onone aoea—thebonedensitVtrst—vvhichisusedtofind and treat serious bone loss and prevent fractures and disability. Much ofthe emphasis for testing has been onwomen, but men are atrisk too. From left: Elizabeth Smith, MelissuHoylo ComtneyRocca, Elena 6sdenski.Absent: Gillian Fish Gillian Fish, occupational therapist, and Elena Uajenski dietitian, were essential tnthis initiative The group held ateaching session onosteoporosis every other month. Participants learned why it|s important toknow about osteoporosis and its impact 28% OFWOMENJnd 3791a OF MEN who suffer a hip fracture will die within one year on your health, how toread labels inorder toincrease your dietary calcium and how toprevent falls aswell as the importance ofexercise and proper body mechanics. The group targeted people aged 65-7Owho didn't come tothe doctor very often. Twenty patients at atime were sent aletter and requisition for abone density test, Those found tobeatlow risk were invited tVthe information session and met with the dietitian to talk about diet, exercise and Vitamin D. People identified asmedium tohigh risk received individual appointments with a nurse practitioner toset upatreatment plan inaddition toattending the information session. The treatment plan consisted wfmedication and/or lifestyle changes, regular monitoring tomake sure the medication was working and repeat bone density tests within 1-3years depending nntheir level ofrisk. yOaresult mfthis foUovv-up,nurse practitioners diagnosed other chronic diseases such as diabetes and high cholesterol insome individuals, and were able to set up a treatment plan for these as well. Healthy Bones Workshop. 71 % of participants reported an increase in their ^ 109 100% were confident they could use the skills learned 3 "Iwas self -medicating —| thought | needed smoking tohelp rnecope with everything I've gone thnough", says Joan'."After being raised b»analcoholic and abusive mother and sexually assaulted atage 14, | was hospitalized after suicide attempts. Then |vvas misdiagnosed with schizophrenia and dependent nnhospitals for lUyears. | lived inpoverty.' Later, Joan was correctly diagnosed with major depression and anxiety disorder She succeeded at some jobs and'turnedher life around abit! MoumitaOhattachariya,the Thames Valley Family Health Team (FVFHT)pharmacist who was helping Joan quit smoking, suggested that she register for the Mind Over Mood program. Joan was doubtful: "| had been ingroups before but high anxiety levels prevented me from continuing" Mind Over Mood was a different experience — she shared things with the group that she hadn't told anyone, and was relieved tofind that the group was supportive and empathetic. Heather Maxwell, a TVFHT social worker who co -facilitates the group, agrees: "Groups are more sUc- cessfui|nfactpost-gnoupsurveysshovvthat participants rank personal support asthe highest benefit ofthe groUp." "Mind Over Mood has put noeinchange",Joan says. "|'velearned toidentify irrational thinking and understand why it's happening. Then | can challenge ' Names changed to protect patient privacy. 4 Mind Over Mood is an program that teaches skills and principles used in cognitive behavioral therapy. Participants learn to identify homi 'thou g [its affect rnoods, and develop skills and strategies to help change their thinking. those thoughts and change them ifnecessary. |in more focused, better able to set and achieve goals.' Managing her moods has helped Joan inother ways: "In the group, |realized that | isolated myself because myupbringing made nneview the world as unsafe. Now |feel healthier physically; I'm socializing more, eating better and exercising. I've even been able hn reduce some ofnnyrnedications." w 89% of patientssay their stress levels have decreased w 70% of patients report HDimprovement 'D depression symptoms ° %«f patientssay their anxiety levels have decreased Joan concluded bysaying: "For years | was inand out ofcounselling and doctors' offices, feeling inadequate. Now | have asense ofself-worth and confidence, and | have tools tohelp nnecontrol thoughts that affect nny moods. | can't compliment Mind Over Mood enough!" ° By the time Canadians reach 40years Ofage, 1iM}have —O[have had —8mental illness. ° Women have higher rates Ofmood and anxiety disorders. ° Only about half »fCanadians experiencing 8major depressive episode receive "potentially adequate care." ° Cost tOsociety: 8growing body Ofinternational evidence demonstrates that promotion, prevention, and early intervention initiatives show positive returns OO investment. ^ Courtesy mthe Centre ovxddimonand Mental Health. 110 INCREASING ACCESS TO 0 Mental HealthServices // / t / /%/ / //� ////�/// //////%..,,.,.///I//I//�O%l//ll//////I/O//G%/////////l/////%/////l/�l%////�///%//��/�l/�%/%/////////l////�//�U//G////(/CSI/I/%�//r�//l/I//�/////�/!///0/I///////OI////1///�//G/��✓/%l/��/lel//I�r//�//////rl//I/�l///I////�%�/%//J/U/l/1/0/1/I//////G,/I///�////�//% It was envisioned as a response to demands for service and designed to improve patient access to mental health services. In this model, the patient's first appointment is a 30 -minute assessment. The patient fills out an intake form which guides discussion; each patient leaves the appointment with a care plan. This model has now spread to most ofTVFHT's 18 locations. Preliminary outcomes confirm the results at the Windemere site: reduced wait times, improved access to services, and a greater ability to accommodate urgent requests (see charts below). "Social workers need to be able to see patients quickly," says Heather Maxwell, social worker at TVFHT's Old South site. "We guide patients to the right care, whether it's a community resource, Wait Time Comparison at Windemere Site (Days) ill Patient Initiated Model �jj RAM 2016 ll RAM 2017 an individual appointment with us, or to TVFHT programs. In primary care, the group model makes sense." Social worker Cheryl Hines, Windemere site, notes: "Every person is heard, and every person leaves with a plan to address their concerns." Teri Allen, social worker at the Southwest Middlesex Health Centre, adds: "The model works seamlessly. My wait lists have decreased significantly, and physicians are pleased that we can see patients much sooner." Other Ontario Family Health Teams have successfully tailored the Rapid Assessment Model to their own needs. Angela Bailey, Humber River Family Health Team, reports that over the last year, there has been a 50% decrease in patients who don't show up to an appointment. Angela says: "People were less anxious because they'd already spoken to us on the phone." TVFHT social workers continue to refine the model based on learnings from other Family Health Teams. As Cheryl notes: "We improve the model and learn more ourselves as we share expertise with our colleagues. Most importantly, this benefits our patients." 111 No Show Rate Comparison at Windemere Site 11 Patient Initiated Model 111111 RAM 2016 in RAM 2017 Xavier' |sanolder adult who was diagnosed with a debilitating autoimmune disease about 25years ago Without realizing it, he had become "complacent" in life. He limited his physical activity, thinking "| just can't do it" Then Xavier decided tnsign upfor the From Soup hm Tomatoes program athis Thames Valley Family Health Team (TVFHT)site. From Soup toTomatoes isanonline chair -based exercise class led by nurse who is also a personal trainer specialist for older adults. Progmnnsva[yin intensity from gentle yoga movements suitable for everyone to resistance training with a little cardio thrown in. class celebrates their 2nd anniversary. TVFHTbegan offering these classes attwo of its rural sites, mainly tohelp older adults who don't have easy access to exercise facilities to manage their diabetes. The program nolonger involves lifting canned goods, but rather has incorporated resistance bands. Erin Hadton,the TVFHTdietitian who originally found this program and championed its adoption atTVFR[ 'Names changed mprotect patiemvmwcy. 2 The first classes used soup cans as weights and joked that as they grew stronger, they'd move to tomato cans! reports that participants have progressed from aneasy resistance band to a much stronger one. Xavier was "hookpd;'andtwo years later hesays "novv|realize that there's exercise out there that | can do..this class motivates nnetomove past my limitations!" Hesays that he's physically more flexible and able to walk slightly longer distances. To Xavier, the mental aspects ofthe class are above and beyond strength and flexibility improvements. Social isolation in older adults often negatively affects physical and mental health, but Xavier notes that through this class participants have made new friends and some are becoming more outgoing. "The camaraderie inthe group isvvonderful,"Xavier says. "|t'sahealthy environment for people. VVecould choose tndothis online athome but being |nclass |s motivating. | would absolutely recommend this class to others!" 112 L00K11MG � R ARD QUALITY, COLLABORATION & E Our strategic I ' (aw 1 a p � - out ,, strong ,,to/' i path h fo, our ` t,, 1juryjy We will build upon our solid foundation and foster a culture of continuous quality improvement. Quality Champions at each of our sites will ensure that we build our capacity in this area. The Thames Valley Family Health Team (TVFHT) will maintain its focus on organizational health and employee retention, with guidance from our employees. We will strive to continue to be an excellent place to work — ensuring that our staff are supported and empowered. Most importantly, we will continue to keep the people we serve at the centre of everything we do. For example: 11at;ient/Caregiver Feedback - In 2018, we are planning several patient/caregiver focus groups to help us understand what patients and caregivers need from us. h: rO( .`Idenh,iq A c erg ;sto i'A( i„i li lRes tirces ....o We are working with local community agencies to open our programs to those patients most in need who currently don't have access to interdisciplinary team -based care. Health Links — We are actively involved in sustaining the gains made by Health Links in our commitment to patient -centred care with collaborative care partners, patients and caregivers. Health Equity -- We continue to focus on activities that look at health equity as a guiding principle. We are committed to raising awareness of cultural humility and diversity through internal training. This will elevate our capacity in providing the best care to all of the people we serve. We are excited to embrace new opportunities and continue on our path of collaboration and innovation. patientsWhat our great , of caring professionals! 'For more informationon our strategic plan, see our website: www.thomesvalleyfht.ca/strategic-directions 113 N VISION As leaders in the provision of primary health care, we will enhance the wellbeing of the people of Thames Valley. M PAN 15:0 5 10 N We are a dynamic primary health care network providing exceptional care. Patient and Family Centred Care: We make a difference in people's lives by providing comprehensive, compassionate care that responds to the evolving needs of our patients and theirfamilies. Trust and Respect: Trust for each other and mutual respect for the unique roles we play as colleagues and professionals is critical to our inter -disciplinary model of patient care. Collaboration and Teamwork: In order to help our patients and families, we value working together as a team of professionals where the contribution of each team member is optimized in a professional atmosphere of camaraderie and collegiality. Honesty and Open Communication: We value open and honest dialogue which promotes information sharing and supports collaborative problem solving. Accountability: We accept our individual and team responsibilities and we meet our commitments. We take responsibility for our actions, our decisions and our performance as both team members and individual professionals. BOARD OF DIRECTORS • Sandra Jansen (Chair) • Aindrea Cramp • Cathy Frederick • Tom Freeman • William George • Lauren Kopechanski • Silvie MacLean • Andrew Nemirovsky • Shamidah Noorani • Stephen Wetmore • Carol Young -Ritchie SENIOR LEADERSHIP • Keri Selkirk, Executive Director • Laura Neumann, Medical Director Thames Valley Family Flealth,rearn By -Law No. 18-20 "BEING A BY-LAW TO ESTABLISH REVENUE NEUTRAL CLAWBACK PERCENTAGES FOR CERTAIN PROPERTY CLASSES" WHEREAS Section 330(1) OF THE Municipal Act, S.O. 2001, c.25 states that the Council of a municipality other than a lower -tier municipality, may pass a by-law to establish a percentage by which tax decreases are limited for a taxation year in respect of properties in any property class subject to Part IX of the said Act in order to recover all or part of the revenues foregone as a result of the application of Section 329 of the said Act to other properties in the property class; and WHEREAS for the purposes of this by-law, the commercial classes shall be considered a single property class and the industrial classes shall be deemed to be a single property class; and WHEREAS limits to tax decreases for any class may only be established in order to recover all or part of the foregone revenue in respect of the same property class. NOW THEREFORE, the Municipal Council of the Corporation of the County of Elgin enacts as follows: 1. THAT for the taxation year 2018, the percentage determined under Section 330(1) of the Municipal Act, S.O. 2001 are as follows: LCommercial Industrial Decrease Clawback 30.1191% 0.0000% Decrease Retained 69.8809% 100.0000% 2. THAT in accordance with the provisions of the Section 330(1) of the Municipal Act, S.O. 2001 the County is deemed to be the banker and no lower tier member municipality shall have a surplus or a shortfall as a result of the application of this By -Law, and further, if the County experiences a shortfall or excess as a result of the application of the banking function under this By -Law, any such shortfall/excess shall belong to the County. 3. THAT the intra -municipal adjustment due to the application of this by-law, with the County acting as the banker, shall be paid by the member municipalities on December 15th, 2018. READ A FIRST, SECOND AND THIRD TIME AND FINALLY PASSED THIS 26th DAY OF JUNE 2018. Julie Gonyou, David Marr, Chief Administrative Officer. Warden. 115 COUNTY OF ELGIN By -Law No. 18-21 "BEING A BY-LAW TO ADOPT OPTIONAL TOOLS FOR THE PURPOSES OF ADMINISTERING LIMITS FOR THE COMMERCIAL, INDUSTRIAL AND MULTI -RESIDENTIAL PROPERTY CLASSES" WHEREAS the County of Elgin (hereinafter called the "Municipality"), in accordance with Section 329.1 of the Municipal Act, 2001, S.O. 2001, c.25, as amended (hereinafter called the "Act"), may modify the provisions and limits as set out in Section 329 of the Act, with respect to the calculation of taxes for municipal and school purposes payable in respect of property in the commercial, industrial and multi -residential property class; and WHEREAS the Municipality must similarly modify the provisions and limits as set out in Section 332 of the Act with respect to the "tenant cap" calculations; and WHEREAS this by-law shall only apply to properties in any of the Commercial, Industrial and Multi -Residential property classes to which Part IX of the Act applies; and WHEREAS for the purposes of this by-law the commercial classes shall be considered a single property class and the industrial classes shall be deemed to be a single property class; and WHEREAS "CVA taxes" means, the taxes for municipal and school purposes that would be levied for the taxation year, but for the application of Part IX of The Act; and AND WHEREAS "capped taxes" means, the taxes for municipal and school purposes that shall be levied for the taxation year as a result of the application of Part IX of The Act; and WHEREAS the Council may pass a by-law to apply any one or any combination of the following options: a) Set the annualized tax limit increase to a maximum of 10%; and/or b) Set an upper limit on annual increases at the greater of the amount calculated under a) and up to 10% of the previous year's annualized CVA tax; and/or c) Establish a capping adjustment threshold of up to $500 for increasing properties, decreasing properties or both, whereby no capping/claw-back adjustments less than the threshold amount would be applied; and/or d) Exclude properties that were at CVA tax in the previous year from the capping and claw -back calculation in the current year; and/or e) Exclude properties that would move from being capped in the previous year to be clawed back in the current year or from being clawed back in the previous year to be capped in the current year as a result of the changes to the CVA tax; and/or f) Exclude Reassessment related increases from the Capping Calculation. WHEREAS a by-law passed to adopt the provisions of Subsection 329.1 paragraphs 1 and 2 of the Act, provides that such provisions shall also apply to Section 332 of the Act with respect to the "tenant cap" calculations; and WHEREAS the Council has reviewed the provisions of Section 329.1 of the Act and hereby deems it necessary and appropriate to adopt optional tools for the purpose of administering limits for the Commercial, Industrial and Multi -Residential property classes. NOW THEREFORE the Municipal Council of the Corporation of the County of Elgin hereby enacts as follows: 116 1WM 1. THAT paragraphs 1, 2, and 3, of Subsection 329.1(1) of the Act shall apply to the Commercial, Industrial and Multi -Residential property classes for 2018. 2. THAT: a) In determining the amount of taxes for municipal and school purposes for the year under Subsection 329(1) and the amount of the tenant's cap under Subsection 332(5), the greater of the amounts determined under paragraphs i) and ii) as set out below shall apply in determining the amount to be added under paragraph 2 of Subsection 329(1), and the increasing amount under paragraph 2 of Subsection 332(5), i) The percentage set out in Subsection 329(1) paragraph 2 and in Subsection 332(5) paragraph 2 shall be ten per cent (10%), and ii) The amount of the CVA taxes for the previous year multiplied by ten per cent (10%). b) The amount of the taxes for municipal and school purposes for a property for a taxation year shall be the amount of the uncapped taxes for the property for the year if the amount of the uncapped taxes exceeds the amount of the taxes for municipal and school purposes for the property for the taxation year as determined under section 329, as modified under section 329.1 of The Act and this By-law, by five -hundred dollars ($500.00) or less. c) The amount of the taxes for municipal and school purposes for a property for a taxation year shall be the amount of the uncapped taxes for the property for the year if the amount of the taxes for municipal and school purposes for the property for the taxation year as determined under section 330, as modified under section 329.1 of The Act and this By-law exceed the uncapped taxes, by five -hundred ($500.00) or less. d) Exclude properties that were at CVA tax in the previous year from the capping and claw -back calculation in the current year. e) Exclude properties that would move from being capped in the previous year to be clawed back in the current year or from being clawed back in the previous year to be capped in the current year as a result of the changes to the CVA tax. f) Exclude Reassessment related increases from the Capping Calculation. THAT this By -Law shall come into force and take effect upon its passing. READ A FIRST, SECOND AND THIRD TIME AND FINALLY PASSED THIS 26th DAY OF June 2018. Julie Gonyou, David Marr, Chief Administrative Officer. Warden. 117 COUNTY OF ELGIN By -Law No. 18-22 "BEING A BY-LAW TO ADD HIGHWAYS, INCLUDING LOWER TIER HIGHWAYS, TO THE HIGHWAY SYSTEM FOR ELGIN COUNTY WHEREAS the Municipal Act, 2001, S.O. 2001, c. 25, as amended, and in particular s. 52 (1), authorizes an upper tier municipality to add a lower tier highway to the highway system of the said upper tier; AND WHEREAS the Corporation of the County of Elgin proposes to add specified highways currently under the registered ownership and/or jurisdiction of the The Corporation of the Township of Malahide to the highway system of the said County of Elgin to facilitate installation and/or construction of a temporary bridge and, thereafter, permanent bridge for access to and egress from the Community of Port Bruce in the said Township of Malahide from County Road 73 (Imperial Road); AND WHEREAS The Corporation of the Township of Malahide, by its Municipal Council, and on conditions, has assented to the addition of such highways to the highway system for the County of Elgin for the said purposes; NOW THEREFORE the Municipal Council of the Corporation of the County of Elgin enacts as follows: 1. THAT with the assent of The Corporation of the Township of Malahide and pursuant to section 52 of the Municipal Act, 2001, S.O. 2001, c. 25, as amended, the portions of the highways set forth and identified in Schedule "A" hereto and as depicted in Schedule "B" hereto be and same are hereby added to the highway system of the Corporation of the County of Elgin. 2. THAT the Warden and Chief Administrative Officer be and are hereby authorized to execute a written agreement with The Corporation of the Township of Malahide setting forth the terms and conditions under which the portions of highways identified in section 1 above are to be added to the highway system of the Corporation of the County of Elgin. READ A FIRST AND SECOND THIS DAY OF , 2018. READ A THIRD TIME AND FINALLY PASSED THIS DAY OF , 2018. Julie Gonyou, David Marr, Chief Administrative Officer Warden 118 COUNTY OF ELGIN By -Law No. 18-23 "BEING A BY-LAW TO DELEGATE AUTHORITY TO THE CHIEF ADMINISTRATIVE OFFICER TO ACT IN THE EVENT THAT THE COUNCIL'S ACTIONS BECOME RESTRICTED UNDER SECTION 275 OF THE MUNICIPAL ACT, 2001." WHEREAS Section 5(3) of the Municipal Act, 2001, c. 25, as amended, authorizes a municipality to pass by-laws to exercise its municipal powers; AND WHEREAS Sections 224(d) and 224(e) of the Municipal Act, 2001, c. 25, as amended, provide that it is the role of council to ensure that administrative practices and procedures are in place to implement the decisions of council and to maintain the financial integrity of the municipality; AND WHEREAS Section 275(1) of the Municipal Act, 2001, c. 25 as amended, restricts the actions of a council of a local municipality after the first day during the election period that the new council will include less than three-quarters of the members of the outgoing council; AND WHEREAS Section 275(3) of the Municipal Act, 2001, c.25, restricts Council from taking action on the following: a) The appointment or removal from office of any officer of the municipality; b) The hiring or dismissal of any employee of the municipality; c) The disposition of any real or personal property of the municipality which has a value exceeding $50,000 at the time of disposal; and d) Making any expenditure or incurring any other liability which exceeds $50,000. AND WHEREAS Section 275(6) of the Municipal Act, 2001, as amended, authorizes councils to delegate authority to persons prior to nomination day for the election of a new council; AND WHEREAS the Council of the Corporation of the County of Elgin deems it expedient to delegate authority to the Chief Administrative Officer to take action, where necessary, on certain acts during the restricted period; NOW THEREFORE the Corporation of the County of Elgin HEREBY ENACTS AS FOLLOWS: 1. THAT, in the event that the Council's actions become restricted under Section 275 of the Municipal Act, 2001, the authority of the Council to act shall be hereby delegated as follows: (a) to the CAO to be the financial signing authority for expenditures, outside the current budget, exceeding $50,000 and/or for the disposition of any real or personal property of the municipality which has a value exceeding $50,000 at the time of disposal; and (b) to the Chief Administrative Officer to be the authority to hire or remove any officer not under the purview of Council from/to employment with the County of Elgin. 2. THAT this By-law shall come into force and take effect on the final passing thereof. READ A FIRST, SECOND AND THIRD TIME AND FINALLY PASSED THIS 26th DAY OF JUNE 2018. Julie Gonyou, David Marr, Chief Administrative Officer. Warden. 119 CLOSED MEETING AGENDA June 26, 2018 Staff Reports: 1) General Manager of Economic Development —Municipal Act Section 239.2 (c) a proposed or pending acquisition or disposition of land by the municipality or local board. 2) County Solicitor — Municipal Act Section 239.2 (f) advice that is subject to solicitor -client privilege, including communications necessary for that purpose,- (k) urpose,(k) a position, plan, procedure, criteria or instruction to be applied to any negotiations carried on or to be carried on by or on behalf of the municipality or local board. 3) County Solicitor - Municipal Act Section 239.2 (e) litigation or potential litigation, including matters before administrative tribunals, affecting the municipality or local board, (f) advice that is subject to solicitor -client privilege, including communications necessary for that purpose; (k) a position, plan, procedure, criteria or instruction to be applied to any negotiations carried on or to be carried on by or on behalf of the municipality or local board. 4) Chief Administrative Officer — Municipal Act Section 239.2 (b) personal matters about an identifiable individual, including municipal or local board employees — Organizational Update 120