ORIGINAL VERSION IS IN FRENCH

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1 ORIGINAL VERSION IS IN FRENCH Minutes of the special meeting of the Board of directors of the Centre intégré de santé et de services sociaux de la Côte-Nord held behind closed doors on March 22, 2017 at noon by conference call. Present.. Denis Miousse, Chairman Claude Belzile, Vice-chair Marc Fortin, President & executive director and secretary Johanne Beaudoin Carold Boies Isabelle Bossé Dave Charlton Josée Francoeur Michel Paul Jean-Pierre Porlier François Tremblay Solange Turgeon. Justified absences. Pascal-Simon Audet Jacinthe Bernard Roger Dubé Roberto Gauthier Patricia Huet Jean-Marie Vollant Guests: Johanne Savard, PDGA, Nathalie Minville (3 & 4) Vicky Lapierre (5) Sandra Morin (6) Lise Boivin (7.1, 7.2 & 7.3) 1. Opening of the special meeting behind closed doors and verification of the quorum The Chairman verified the quorum and declared the special meeting open at 12:09 p.m. 2. Reading of the agenda The Chairman read the agenda. 3. Tariff schedule for parking areas Within the framework for harmonizing the practices of the CISSS de la Côte-Nord, a new institutional policy on the management and use of parking areas is presently being discussed with different internal authorities. However, the MSSS recently issued a new circular making it mandatory for institutions to comply with new tariff guidelines. This update follows the coming into effect of the Act to modify the organization and governance of the health and social services network, in particular by abolishing the regional agencies. Tariff schedule for parking areas Whereas circular issued by the MSSS in September 2016 is aimed at standardizing the tariff policies of parking areas enforced by the facilities of the CISSSs and CIUSSSs; Whereas the Board of directors of an institution must authorize the tariff policy of its parking areas or decline a tariff policy, regardless of the entity that operates it; Whereas the recommendation made by the consulting committee regarding the new tariff schedule for the CISSS de la Côte-Nord; To adopt the tariff schedule of the parking areas at the CISSS de la Côte-Nord, and To mandate the Department of technical services and capital assets to enforce its application. 4. Request for authorization from the ministère du Développement durable, de l Environnement et de la Lutte contre les changements climatiques regarding energy saving project in Minganie On April 15, 2016, an agreement was signed between the Centre intégré de santé et de services sociaux de la Côte-Nord and Services énergétiques Ecosystem Inc. (ESE), to set up a project aimed at generating savings through the implementation of energy efficiency measures. This project involves two buildings part of the Minganie facilities, namely the hospital and seniors home of Havre-Saint-Pierre.

2 The open geothermal work planned by ESE requires the authorization from the ministère du Développement durable, de l Environnement et de la Lutte contre les changements climatiques (MDDELCC). Two forms need to be filled out by at least four members of the Board of directors. Request for authorization from the ministère du Développement durable, de l Environnement et de la Lutte contre les changements climatiques regarding energy saving project in Minganie Whereas the form for the request for authorization to withdraw water subject to section of the Environment Quality Act (RLRQ, chapter Q-2) is completed as required in order to carry out the open geothermal work planned for the energy saving project in Minganie; Whereas the statement of the applicant containing the information required under section of the Environment Quality Act (RLRQ, chapter Q-2) is completed as required in order to carry out the open geothermal work planned for the energy saving project in Minganie; To authorize Marc-Olivier Poulin from Services énergétiques Ecosystem Inc. (ESE), to sign on behalf of the Centre intégré de santé et de services sociaux de la Côte-Nord any request for authorization addressed to the ministère du Développement durable, de l Environnement et de la Lutte contre les changements climatiques (MDDELCC) under the Environment Quality Act as well as any other documents required under section of this same act; To designate, within the framework of this project, four members of the Board of directors of the Centre intégré de santé et de services sociaux de la Côte-Nord to fill out the forms requested by the MDDELCC, namely: Denis Miousse Marc Fortin Jean-Pierre Porlier Isabelle Bossé 5. Compensatory leave for management staff The different local management policies (LMPs) currently in effect include arrangements involving the notion of compensatory, floating and personal leave. In the fall of 2016 and in January 2017, the MSSS issued guidelines to abolish all arrangements of this nature. At this time, the Department of human resources, communication and legal affairs is working in collaboration with two managements associations of the CISSS (APER and AGESSS) to review and harmonize local management policies (LMPs). Much like the harmonization of vacation time (six weeks), the institution must now ensure that arrangements made with respect to these types of leave no longer apply. Compensatory leave for management staff Whereas the 1st subparagraph of chapter 3 of the Regulation respecting certain terms of employment applicable to officers of agencies and health and social services institutions states that In general, no remuneration or compensation shall be paid to an officer for the overtime occasionally required in carrying out his regular duties. Whereas the ministerial guideline of October 19, 2016 requires institutions to cease this practice; Whereas the current local management policies of ex-institutions contain arrangements involving the notion of compensatory leave; Whereas it is no longer possible to grant any form of compensation for the overtime occasionally required; To render invalid any arrangement involving compensatory leave found in the local management policies (LMPs) of ex-institutions; To accept, as presented, the amendment to the current LMPs involving compensatory leave.

3 6. Modification to operating permit University Family Medicine Group As of April 1st, 2017, the management framework for the University Family Medicine Groups (UFMG) will become effective. As a result, the designation UFMG will be generalized throughout the family medicine units (FMU) of the province of Quebec and will need to appear on the operating permit. In our region, there is only one family medicine unit. The Manicouagan FMU is located on the premises of the CLSC Lionel-Charest at 340 rue Clément-Lavoie in Baie-Comeau. Consequently, a request for the modification of this institution s operating permit will be forwarded to the MSSS. Modification to the operating permit University Family Medicine Group (UFMG) Whereas the orientations of the ministère de la Santé et des Services sociaux aim to replace the designation family medicine unit (FMU) with university family medicine group (UFMG) thus emphasizing a clinical rapprochement between the UFMGs and the other first line service providers, including the family medicine groups (FMGs); Whereas on April 1st, 2017, the designation UFMG will be generalized throughout the FMUs of Quebec, whether they have signed on to the Financial and professional support program for FMGs or not; Whereas this process may lead to a modification of the institution s permit: such as modifying the entities registered on the permit, adding a mission exercised at a facility or creating of a new facility; Whereas these modifications may lead to a change in the name of the facility in compliance with the framework regarding the naming of institutions and facilities of the health and social services network of the Ministère; Whereas the administrative merger of facilities with the same civic address will lead a new permit number to be issued for the created facility; Whereas the CISSS de la Côte-Nord is a public institution established under the Act to modify the organization and governance of the health and social services network, in particular by abolishing the regional agencies (AMHSSN) (RLRQ, chapter O-7.2); Whereas under section 444 of the Act respecting health services and social services (RLRQ, chapter S- 4.2), the activities of a permit holder must be carried on within the scope of his permit; Whereas the Health and social services minister must authorize all modifications made to an operating permit issued to an institution; Whereas the CISSS de la Côte-Nord agrees to initiate steps aimed at standardizing its operating permit; To ask the Health and social services minister to add university family medicine group to the mission of the general and specialized health care centre at the following facility: CLSC Lionel-Charest ( ); To ask the Health and social services minister to change the name of the facility CLSC Lionel-Charest for: «Groupe de médecine de famille universitaire and CLSC Lionel-Charest»; That the CISSS de la Côte-Nord agrees to post, at all times, the issued permit in public view; To authorize Marc Fortin, president and executive director, to take all actions necessary to give effect to this resolution. 7. Medical affairs 7.1 Appointment of active members Appointment of active members Whereas the application for appointment as an active member on the Council of physicians, dentists and pharmacists of the Centre intégré de santé et de services sociaux de la Côte-Nord along with the privileges specified for each member and the facility designated for each member are as stated below: Whereas the provisions of the 3rd paragraph of section 190 of the Act respecting health services and social services are invoked; Whereas the provisions of section 61 of the Act to modify the organization and governance of the health and social services network, in particular by abolishing the regional agencies (AMHSSN) are invoked;

4 Whereas the files are analyzed and receive a favourable recommendation by the credentials committee; Whereas a favourable recommendation is made by the executive committee of the Council of physicians, dentists and pharmacists (CPDP); Whereas CPDP members respect their commitment to privileges, such as respecting the regulations of their department, their institution and the CPDP; To proceed with the appointment of each of the members listed below (name, specialty, licence number); To grant them the status of active member on the Council of physicians, dentists and pharmacists of the Centre intégré de santé et de services sociaux de la Côte-Nord at the specified facility (if privileges at several facilities, specify location of principal practice); To grant them the exercise of privileges based on the list following this resolution and for the determined period: Licence no. Title Name Specialty Privileges Facility Period CPDP resolution no Maxime Dubé Pharmacist Pharmacist Manicouagan From Jan. 30, 2017 to Dec. 31, Doctor Élisabeth Morin Family physician Family physician Sept-Îles From March 29, 2017 to Dec. 31, 2018 CPDP CPDP Conditional on her supplying proof of having subscribed to professional liability insurance. 7.2 Modification of status and privileges Modification of status and privileges Whereas each of the members of the Council of physicians, dentists and pharmacists request to proceed with the modifications listed below; Whereas the provisions of the 3rd paragraph of section 190 of the Act respecting health services and social services are invoked; Whereas a favourable recommendation is made by the credentials committee; Whereas a favourable recommendation is made by the management committee of the CPDP; Whereas CPDP members respect their commitment to privileges, such as respecting the regulations of their department, their institution and the CPDP; To proceed with the modifications requested by the members as listed below; That these changes become effective at the specified date: Licenc e No Doctor Laurent Thibeault Psychiatrist Modify current status of associate member to that of active member Title Name Specialty Requested modification Facility Period Manicouagan From April 3, 2017 To Dec. 31, 2019 Resolution no. CPDP Doctor Christian Mercier Family physician Modify current status of part-time active member to that of full-time active member Fermont From Feb. 1, 2017 To Dec. 31, 2019 CPDP Doctor Félix Richard-Chapleau Family physician Add emergency privileges for Forestville facility Manicouagan From Jan. 1, 2017 To Dec. 31, 2019 CPDP Doctor Charles Breau Family physician Add emergency ultrasound privileges Port-Cartier From Jan. 1, 2017 To Dec. 31, 2018 CPDP Appointment of Assistant Head of the Family Medicine Department Our recent assistant head was Julie Léger who resigned and left on February 15, 2017.

5 Appointment of Assistant Head of Family Medicine Department Whereas Dr. Julie Léger resigned as assistant head of the family medicine department; Whereas it was voted unanimously to appoint Dr. Christine Ricard as assistant head of the regional family medicine department; Whereas Dr. Julie Léger left her position on February 15, 2017; Whereas the executive committee of the Council of physicians, dentists and pharmacists Resolution CPDP made a recommendation; To accept the appointment of Dr. Christine Ricard (licence n o 13566), as Assistant head of the regional family medicine department, active member of the CPDP at the Sept-Îles facility, effective February 15, Resignation of a director In a letter addressed to Minister Gaétan Barrette and dated March 1 st, 2017, Patricia Huet explained her decision to resign as director effective March 15, Under section 20 of the AMHSSN, the vacancy is filled by the Minister, who is not required in such a case to follow the appointment rules set out in sections 15 and 16. The Minister may, however, request the institution s president and executive director to propose candidates. The assistant to the President and executive director and media relations officer has called on the MSSS to find out the exact steps to take. Many members have declared that the motives stated by Huet with respect to her resignation are inappropriate. This fact will be emphasized in the letter thanking her for her years of service. Whereas Patricia Huet resigned; Whereas the Board of directors must acknowledge it; Resignation of a director Patricia Huet To accept the resignation of Patricia Huet, independent member of the Board of directors of the Centre intégré de santé et de services sociaux de la Côte-Nord, expert in finance-accounting-risk management, effective March 15, 2017; To start the process of filling the vacant seat for the remainder of the term. 9. Closing to adjourn the meeting at 1:01 p.m. Denis Miousse Chairman Marc Fortin Secretary ADOPTED ON: MEETING SECRETARY: Andrée Tremblay

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