Finance Committee Report BH.04.OCT1316.R13
October 13, 2016
Report to: Finance Committee, Board of Health
Submitted by: Elizabeth Bowden, Interim Director of Administration
Subject: 2016 MOHLTC FUNDING APPROVAL
Recommendations
(a) The Finance Committee make recommendation to the Board of Health to receive this report, for information.
Background
WDGPH receives ongoing funding from several sources: the Ministry of Health and LongTerm Care (MOHLTC), the Ministry of Children and Youth Services (MCYS), the City of Guelph, the County of Wellington, the County of Dufferin, the Public Health Agency of Canada (PHAC), and other community partners.
This report pertains to funding received from the MOHLTC. This funding approval does not apply to the MCYS 100% provincially funded programs (HBHC and Preschool Speech and Language), the 100% municipally funded program (County of Wellington Wee Talk), the PHAC 100% federally funded program (Canadian Prenatal Nutrition Program), or any community partner funding.
Some of the MOHLTC funded programs are cost-shared with the three obligated municipalities, and some of them are 100% provincially funded programs. Within the programs that are cost-shared with the municipal funders, there are two categories: CostShared Mandatory, and Cost-Shared Related. Cost-Shared Mandatory funding is provided as one lump sum for a number of programs. The Board of Health approves the allocation of this funding to programs via the annual budget prepared by management. Cost-Shared Related funding is provided directly for two specific programs, and any excess funds from one program cannot be used to offset a deficiency in another program. Throughout this report, the various pieces of funding will reference the following numbering system:
| No. | Program/Budget Name | Funder(s) | Year-end |
|---|---|---|---|
| 1 | Cost-shared Mandatory Programs | Ministry of Health and Long-Term Care (MOHLTC); City of Guelph; County of Wellington; County of Dufferin | December 31st |
| 2 | Cost-shared Related Programs | Ministry of Health and Long-Term Care (MOHLTC); City of Guelph; County of Wellington; County of Dufferin |
December 31st |
| 3 | 100% MOHLTC Funded Programs | Ministry of Health and Long-Term Care | December 31st |
(1) Cost-Shared Mandatory programs are:
- Chronic Disease Prevention;
- Prevention of Injury and Substance Misuse;
- Reproductive Health;
- Child Health;
- Public Health Emergency Preparedness;
- Food Safety;
- Safe Water;
- Health Hazard Prevention and Management;
- Infectious Diseases Prevention and Control;
- Rabies Prevention and Control;
- Sexual Health, Sexually Transmitted Infections and Blood-borne Infections;
- Tuberculosis Prevention and Control;
- Vaccine Preventable Diseases; and
- Administrative and overhead expenses.
(2) Cost Shared Related programs are:
- Vector Borne Diseases; and
- Small Drinking Water Systems.
(3) 100% MOHLTC funded programs are:
- Chief Nursing Officer Initiative;
- Enhanced Food Safety Initiative;
- Enhanced Safe Water Initiative;
- Healthy Smiles Ontario Program;
- Infection Prevention and Control Nurses Initiative;
- Infectious Diseases Control Initiative;
- Needle Exchange Program;
- Smoke Free Ontario; and
- Social Determinants of Health Nurses Initiative.
On September 4, 2015, the MOHLTC implemented a new funding model for Public Health which was called an “Equity-Adjusted Population Model”. It contained Service Cost Drivers, and Drivers of Need, with indicators under each as follows:
Service Cost Drivers:
- Geography; and
- Language.
Drivers of Need:
- Aboriginal;
- Ontario Marginalization Index; and
- Preventable Mortality Rate.
Scores for each health unit were calculated for each indicator, the indicators were combined, and population numbers were factored in to arrive at a target percentage share of overall public health funding for each health unit. This target percentage was then compared with the actual percentage for each health unit, to identify over and under funded health units according to the new model.
Under this formula, in 2015, eight health units were identified as being under-funded; twenty-eight health units were considered over-funded. Over-funded health units received a 0% increase in funding for 2015 and were told to expect the same for 2016, although uncertainty about the future use of the funding model was expressed by the Ministry at that time. The eight health units that were considered under-funded split 2% growth funding that was provided for the public health sector.
The MOHLTC has confirmed that the public health funding model was again used for the 2016 funding approvals, and that 1% growth funding was split among ten health units who were considered under-funded. Health units considered over-funded again received a 0% increase in funding.
On October 7, 2015, the Board of Health voted on a Cost-Shared Mandatory and Related programs budget for 2016 which featured a 0% provincial base funding increase.
In addition, one-time grant requests totalling $1,068,654 (provincial portion) were submitted for the 2016 fiscal year as outlined in Finance Committee Report BH.04.MAR1016.R05 – One-Time Grants 2016.
Analysis/Rationale
Overview The 2016 Provincial Funding Approval letter was received by WDGPH on September 23, 2016. Overall, a reduction of $217,400 was received from MOHLTC over the 2015 funding levels, however, this decrease is due to the changes to public health’s role in the delivery of the oral health programs, so 2016 expenditures were also reduced by an equivalent amount. A reallocation of funds between the (1) Cost-Shared Mandatory programs budget and the (3) 100% MOHLTC funded Healthy Smiles Ontario program also took place, and likewise the costs related to delivering these programs have been re-allocated within WDGPH’s operating budget to align with the way the funding is provided. No staffing reductions were required as a result of this funding approval. The impact on the 2017 draft budget is limited to the reallocation of resources between the (1) Cost-Shared Mandatory programs budget and the (3) 100% MOHLTC Funded Healthy Smiles Ontario program budget. Provincial one-time grants totalling $226,800 (provincial portion only) were approved. All of the one-time grants received were 100% provincially funded.
The details of the base funding requested versus funding received for 2016, as well as the details of funding received for 2016 versus funding received for 2015 can be found at Appendix “1”. Details of one-time grant funding requested versus funding received for 2016 are provided at Appendix “2”.
Overview of Appendix “1”
(1) Cost-Shared Mandatory Programs – an increase totalling 0.0% ($0) was requested for these programs. A 2.2% decrease or reduction of $263,700 was provided. The reduction was related to the oral health programs integration, and as a result, the overall impact is actually a 0% increase.
(2) Cost-Shared Related Programs:
Small Drinking Water Systems - Provincial funding of $41,079 was requested for the Small Drinking Water Systems program; however $40,600 (a difference of $479) in funding was provided. This is the same level of funding as was provided for 2015.
Vector Borne Diseases – Provincial funding of $154,666 was requested for the Vector Borne Diseases program, and the amount of funding that was provided was $150,700. This is the same level of funding as was provided for 2015.
(3) 100% MOHLTC Funded Programs:
The following 100% MOHLTC Funded Programs received an increase for 2016 over the 2015 funding amount:
- Healthy Smiles Ontario – a 3.53% or $27,100 increase (related to the oral health programs integration and reflecting a transfer of resources from the Cost-Shared Mandatory programs budget into the Healthy Smiles Ontario program budget rather than an overall increase in resources).
- Needle Exchange Program – a 38.4% or $19,200 increase.
The following 100% MOHLTC Funded Programs received the same funding as was provided in 2015:
- Chief Nursing Officer Initiative;|
- Enhanced Food Safety;
- Enhanced Safe Water;
- Infection Prevention & Control Nurses Initiative;
- Infectious Diseases Control Initiative;
- Smoke Free Ontario;
- Electronic Cigarettes Act;
- Social Determinants of Health Nurses Initiative; and
- MOH/AMOH Compensation Initiative.
Overview of Appendix “2”
In Appendix “2”, information about the 2016 one-time grants requested and received is presented. For all one-time grants requested, information about whether or not the project is moving forward, the status of the project, and the source of funds if no one-time grant funding was approved for the project, is provided.
WDGPH management has requested a teleconference with the MOHLTC to review the 2016 funding approval, including the one-time grant requests that were not approved.
The MOHLTC has indicated that health units may be invited to submit in-year one-time grant requests sometime in the fourth quarter. Depending on the information provided by the MOHLTC during the teleconference, unsuccessful one-time grant applications may be resubmitted through this in-year process if they are eligible.
Appendices
Appendix “1” – Analysis of 2016 Provincial Funding Approval (Base Funding)
Appendix “2” – Analysis of 2016 Provincial Funding Approval (One-Time Grants)
Prepared by: Shanna O’Dwyer Manager, Finance, Administrative Services
Reviewed by: Elizabeth Bowden, Interim Director, Administrative Services
Approved by: Dr. Nicola Mercer, Medical Officer of Health & CEO
