BH.MAR2819.R03 - 2018 Fourth Quarter Financials

RECOMMENDATION(S)

(a) That the Finance + Facilities Committee makes recommendation to the Board of Health to receive the 2018 Fourth Quarter Financials, as presented, for information.

BACKGROUND

Wellington-Dufferin-Guelph Public Health’s (WDGPH) annual budget consists of several subbudgets based on different funders and funding structures. The sub-budgets have been numbered and these numbers have been used consistently throughout this report. The main budget of the organization consists of the sub-budgets numbered (1) through (7) below. In addition to the main budget, WDGPH receives several community grants for projects which are aligned with and build upon the work of WDGPH in the community. These community grants are numbered (8) through (12) below.

The 2018 budget, approved by the Board of Health in late 2017, included sub-budgets (1), (2), and (3) above. These sub-budgets, along with the One-Time Grant requests (13) were submitted to the MOHLTC via the Program Based Grants (PBG) submission in March 2018. The provincial funding approval from the MOHLTC was received May 2018.

PUBLIC HEALTH AND/OR FINANCIAL IMPLICATIONS:

Appendix “1”: Cost-shared Mandatory Programs (1)

Cost-shared Mandatory Programs are the public health programs and services that are funded by the MOHLTC and the three obligated municipalities under Regulation 553 of the Health Protection and Promotion Act (HPPA): the County of Wellington, the County of Dufferin, and the City of Guelph. Boards of health are responsible for allocating this funding to meet the requirements of the HPPA, the Ontario Public Health Standards (OPHS) and Protocols, and the Ontario Public Health Organizational Standards, according to local needs and priorities.

Current Net Position:

Appendix “1” represents the statement of revenue and expenditures for the year ended December 31, 2018, for the Cost-Shared Mandatory programs.

Overall Year-end Surplus:

As reported on the attached statement at Appendix “1”, there was a surplus totalling $407,616 for the year - $250,000 of which was transferred to Orangeville Reserve Fund to support the third-floor renovations project. As a result the remaining year-end surplus for 2018 is $157,616.

Budget to actual variances of greater than $100,000 are explained as follows:

Salary and benefits: Salary and benefits variances, often referred to as “gapping dollars”, are funds that arise from employee leaves and vacant positions (e.g., maternity, paternity, STD, LTD, retirements, resignations, etc.). In 2018, higher than average staff vacancies combined with under budgeted benefit costs, resulted in a positive variance of $639,651. There is an internal process in place to ensure effective utilization of these variances within the organization, and that WDGPH is able to maintain effective service levels.

Information and IT Equipment: In 2018 the information and IT Equipment budget envelope experienced a negative budget variance of ($151,749). This variance came in response to a number of strategic IT decisions made by the organization, including: security upgrades to ensure a minimization of successful cyber-attacks which was based on the fall 2018 IT security audit, hardware refreshes to ensure high availability of resources for the agency, and laptop upgrades in response to the Windows 7 end-of-life cycle.

Appendix “2”: All Other Programs (2 – 12)

Appendix “2” presents the funding and expenditures for the period for all other ongoing programs at WDGPH.

In 2018, all funding for these other programs were fully spent with the exception of Vector-Borne Diseases which had a small variance of $739.

March 31st year-end programs/initiatives:

• Both the Preschool Speech and Language and Canadian Prenatal Nutrition Programs appear to be in a deficit position as of December 31st, however this is based on the timing of cash flows for these programs. Management expects to come in on budget for both of these programs as of their March 31st year-ends.

MOHLTC Cost-shared Related Programs

Vector Borne Diseases – funding provided for this program must be used for the ongoing surveillance, public education, prevention and control of all reportable and communicable vector-borne diseases and outbreaks of vector-borne disease, which include, but are not limited to, West Nile Virus and Lyme Disease.1

Small Drinking Water Systems – this funding is provided to support the ongoing assessments and monitoring of small drinking water systems. Under this program, public health inspectors are required to conduct new and ongoing site-specific risk assessments of all small drinking water systems within the oversight of the Board of Health; ensure system compliance with the regulation governing the small drinking water systems; and ensure the provision of education and outreach to the owners/operators of small drinking water systems.1

MOHLTC 100% Funded Related Programs

Needle Exchange – This funding is provided for the purchase of needles and syringes, and their associated disposal costs, for the Board of Health’s Needle Exchange Program.1

Enhanced Food Safety – This initiative was established to augment the Board of Health’s capacity to deliver the Food Safety Program.1

Healthy Smiles Ontario – This program provides prevention and basic treatment services for children and youth from low-income families who are 17 years of age or under and who do not have access to any form of dental coverage.1

Infectious Diseases Control Initiative –This funding is provided for the sole purpose of monitoring and controlling infectious diseases and enhancing the Board of Health’s ability to handle and coordinate increased activities related to outbreak management.1

Smoke Free Ontario – This funding is provided in support of the government’s Healthy Change Strategy and Action Plan. The Smoke-Free Ontario Strategy is a multi-level comprehensive tobacco control strategy aiming to eliminate tobacco-related illness and death by preventing experimentation and escalation of tobacco use among children, youth and young adults; increasing and supporting cessation by motivating and assisting people to quit tobacco use; and protecting the health of Ontarians by eliminating involuntary exposure to second-hand smoke.1

Electronic Cigarettes Act – This funding was provided to prepare for the implementation and enforcement of the Electronic Cigarettes Act (ECA) which was effective January 1, 2016.

Enhanced Safe Water – The purpose of this initiative is to increase the Board of Health’s capacity to meet the requirements of the Safe Water Program Standard under the OPHS.1

Chief Nursing Officer – Funding is provided for the Chief Nursing Officer position at WDGPH. The purpose of the Chief Nursing Officer position in each Board of Health is to enhance the health outcomes of the community at individual, group and population levels, through contributions to organizational strategic planning and decision making; by facilitating recruitment and retention of qualified, competent public health nursing staff and by enabling quality public health nursing practice.1

Infection Prevention and Control Nurse – This funding is provided to contribute to the cost of a Public Health Nurse, and the majority of the nurse’s time must be spent on infection prevention and control activities.1

Social Determinants of Health Nurses Initiative – With this funding, public health nurses with specific knowledge and expertise on social determinants of health and health inequities issues will provide enhanced supports internally and externally to the Board of Health to address the needs of priority populations impacted most negatively by the social determinants of health in the Board of Health area.1

MOH Compensation Initiative – Funding is provided by the Province to subsidize the salary/benefits/stipends for the Medical Officer of Health to ensure compensation falls within the salary ranges outlined in the 2012 Physician Services Agreement and subsequent addendums to that agreement.1

MCYS Funded Programs

Healthy Babies Healthy Children – The MCYS provides funding for this program with the goal of helping children get a healthy start in life. The program does this by helping infants and children up to age six and their families through screening and assessments, supports for new parents and help in finding community programs and resources.2

Preschool Speech and Language – As the lead agency for the Wellington-Dufferin-Guelph area Preschool Speech and Language Program, WDGPH coordinates the provision of speech pathology services delivered by Groves Memorial Community Hospital, North Wellington Health Care Corporation and St. Joseph’s Health Centre. This funding has a fiscal year of April to March.

County of Wellington Wee Talk - This funding is provided by the County of Wellington to integrate with the speech pathology services available in Wellington County funded by the MCYS under the Preschool Speech and Language program.

Canadian Prenatal Nutrition Program - This funding is provided by the PHAC, on an April to March fiscal year, to deliver a comprehensive program to promote and support optimal nutrition and health in pregnant and early postpartum women who live in difficult life situations.3

Other Community Grants - Various other community grants are provided by the municipalities served by WDGPH and other community partners, including: Family and Children’s Services Guelph-Wellington, United WayWellington-Dufferin-Guelph, Dufferin Coalition for Kids, Women’s College Hospital, Dufferin Child and Family Services, KidsAbility, and Canadian Mental Health Association Waterloo Wellington. The work undertaken with this funding aligns with the mandate of WDGPH under the HPPA, OPHS and Organizational Standards. This funding provides additional resources to WDPGH to augment the work of the Agency.

Appendix “3” – One-time Grants

Appendix “3” presents the one-time grants approved as part of the 2017 Provincial Funding Approval which were deferred to the first quarter of 2018 in accordance with the funding approval provided by the MOHLTC, as well as the approved 2018 one-time grants.

REFERENCES:

1. Ontario. Ministry of Health and Long-Term Care. Financial Planning, Accountability and User Guide for Program-Based Grants for Mandatory and Related Public Health Programs and Services; 2015.

2. Ministry of Children, Community and Social Services [homepage on the Internet]. Available from: http://www.children.gov.on.ca/htdocs/English/topics/earlychildhood/healt….

3. Canada. Public Health Agency of Canada. Canada Prenatal Nutrition Program Contribution Agreement; October 2013.

APPENDICES:

Appendix “1” – Statement of Revenue & Expenditures for the year ended December 31, 2018 – Cost-Shared Mandatory Programs

Appendix “2” – Q4 Financial Report 2018: All Other Programs

Appendix “3” – Q4 Financial Report 2018: 100% MOHLTC Funded One-Time Grants

Prepared by: Robert Cunnington, Manager, Finance

Reviewed by: David Kingma, Director of Administrative Services

Approved by: Dr. Nicola Mercer, Medical Officer of Health & CEO

APPENDIX “1”

Wellington-Dufferin-Guelph Public Health

Statement of Revenue and Expenditures

Total Cost-Shared Mandatory Programs

For the Year Ended December 31, 2018

* Variances greater than $100,000 are explained in the body of the accompanying report.

APPENDIX “2”

Wellington-Dufferin-Guelph Public Health

Q4 Financial Report 2018

All Other Programs (2 through 13)

APPENDIX “3”

Wellington-Dufferin-Guelph Public Health APPENDIX “3”

Q4 Financial Report 2018

100% MOHLTC Funded One-Time Grants (14)