Report to: Finance + Facilities Committee, Board of Health
Submitted by: Dr. Nicola Mercer, MOH / CEO
Subject: 2019 THIRD QUARTER FINANCIALS
(a) That the Finance + Facilities Committee makes recommendation to the Board of Health to receive the 2019 Third Quarter Financials, for information.
Wellington-Dufferin-Guelph Public Health’s (WDGPH) annual budget consists of several sub-budgets that are based on the way funding is provided to the Agency. These sub-budgets have been numbered in the report that follows and the numbering sequence is used consistently throughout. WDGPH’s main budget 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 (14) below. WDGPH’s cost-shared budgets (1 & 2) comprise approximately 80% of the overall budget. This funding is provided on a 60-40 split basis between the Ministry of Health (MOH) and the three Municipalities that WDGPH exists to serve. Appendix 1 provides details of the financial activities that relate to these budgets for Board of Health (BOH) review. As previously discussed with the BOH, the Agency is taking steps to reduce its liabilities in advance of the amalgamation set to occur in April 2020.
|1||Cost-shared Mandatory Programs||Ministry of Health (MOH); City of Guelph; County of Wellington; County of Dufferin||December 31|
|2||Cost-shared Related Programs||MOH; City of Guelph; County of Wellington; County of Dufferin||December 31|
|3||100% MOH Funded Programs||MOH||December 31|
|4||Healthy Babies Healthy Children||Ministry of Children, Community and Social Services (MCCSS)||December 31|
|5||Preschool Speech and Language||MCCSS||March 31|
|6||Inclusion Support Services||County of Wellington||December 31|
|7||Canadian Prenatal Nutrition Program (CPNP)||Public Health Agency of Canada (PHAC)||March 31|
|8||Poverty Elimination Task Force (PETF)||City of Guelph, County of Wellington, United Way Wellington-Dufferin-Guelph||December 31|
|9||Children’s Report Card||County of Wellington||December 31|
|10||Evidence Informed Planning Project||Dufferin Coalition for Kids||March 31, 2019|
|11||Preventing Cannabis Harms Through A Youth Driven Campaign||Gambling Research Exchange Ontario||March 28, 2019|
|12||Mental Health and Addictive Disorders Prevention Program for Grade 7 Students||Gambling Research Exchange Ontario||March 29, 2019|
|13||ElderTALK||Gambling Research Exchange Ontario||December 31, 2019|
|14||Climate Change||Health Canada||
March 31, 2019
|15||One-Time Grants||MOH||March 31|
The 2019 budget, which was approved by the BOH on March 6, 2019, included sub-budgets (1), (2), and (3) above. These sub-budgets, along with the One-Time Grant requests (15) were submitted to the MOH via the Annual Service Plan and Budget Submission on March 6, 2019. The provincial funding approval from the MOH was received on August 20, 2019.
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 MOH 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 Accountability Framework, according to local needs and priorities.
Current Net Position:
Appendix “1” represents the statement of revenue and expenditures for the nine months ended September 30, 2019 for the Cost-Shared Mandatory programs.
As reported on the attached Statement of Revenue and Expenditures at Appendix “1”, there was a positive variance of $239,481 representing 1.5% of the budgeted spending for the first nine months of the fiscal year. Based on a review of expenditures to date and any significant commitments in our financial system at this time, a modest surplus is expected at year-end. Budget to actual variances of greater than $100,000 are explained below:
Salary and benefits expenses were $178,712 under budget due to vacant positions and leaves of absence (medical and parental leaves). Funds from leaves and vacant positions are commonly referred to as “gapping dollars”. There is an internal process for managing variances within the organization and a year-end surplus is not projected in salaries and benefits.
Professional and purchased services expenses were $225,064 under budget for the period. Major contributors to this variance are lower than budgeted legal fees, consulting fees, clinic physician costs, and program advertising.
Building Occupancy expenses were $257,052 over budget for the period, mainly due to the expenditure for Orangeville office renovations of approximately $300,000. This expense was originally slated to be funded solely using Building Reserves but is currently reported as an operating expense as directed by the BOH.
Information and IT equipment expenses were $157,872 over budget for the period, mainly due to the expenditure of approximately $175,000 for the procurement of Enterprise Resource Planning software (Sparkrock), which originally was slated to be funded solely using IT Reserves but is currently reported as an operating expense as directed by the BOH.
Appendix “2”: All Other Programs (2 – 14)
Appendix “2” presents the funding received and expenditures made for the period for all other ongoing programs/initiatives at WDGPH. For these programs funding is recorded as it is received (on a cash basis) throughout the year. Accruals and deferrals are made as required only at year-end. The timing of receipt of funding may not correspond to the planned expenditures for that funding (for example, in the case of the Vector-Borne Diseases program, funding is flowed evenly throughout the year, but a large portion of that funding is spent over the summer months for mosquito larvaciding). Funds received for all programs/initiatives are expected to be fully spent in 2019. A description of each of the programs on Appendix “2” follows: MOH 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 aquired to conduct new and ongoing site-specific risk assessments of all small drinking water systems within the oversight of the BOH; 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 MOH 100% Funded Related Programs
Needle Exchange – This funding is provided for the purchase of needles and syringes, and their associated disposal costs, for the BOH’s Needle Exchange Program.1
Enhanced Food Safety – This initiative was established to augment the BOH’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 BOH’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 for the implementation and enforcement of the Electronic Cigarettes Act (ECA).
Harm Reduction Program Enhancement – This funding is provided to help the BOH address local Opioid use through three main areas:
- Local Opioid Response;
- Naloxone Distribution and Training; and
- Opioid Overdose Early Warning and Surveillance.
Enhanced Safe Water – The purpose of this initiative is to increase the BOH’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 BOH 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 BOH to address the needs of priority populations impacted most negatively by the social determinants of health in the BOH area.1
MOH/AMOH Compensation Initiative – Funding is provided by the Province to subsidize the salary/benefits/stipends for the Medical Officer of Health and Associate 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
MCCSS Funded Programs
Healthy Babies Healthy Children – The MCCSS 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.
Other Funded Programs
County of Wellington Weetalk - This funding is provided by the County of Wellington for a program called Weetalk. Weetalk funds Speech Language Pathologists (SLPs) in licensed childcares to provide support to staff to integrate children with language challenges fully into their programs. 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: United Way Wellington-Dufferin-Guelph, Dufferin Coalition for Kids, and Gambling Research Exchange Ontario. The work undertaken with this funding aligns with the mandate of WDGPH under the OPHS.
Appendix “3” – One-time Grants
Appendix “3” presents the one-time grants approved as part of the 2018 Provincial Funding Approval which were deferred to the first quarter of 2019 in accordance with the funding approval providedby the MOH, as well as the approved 2018 one-time grants. The 2018 one-time grants were approved for use between April 1, 2018 and March 31, 2019. Funds remaining from the one-time grant for the ERP software will be used to offset expenditures on this system in 2019. APPENDICES:
- Appendix “1” – Statement of Revenue & Expenditures for the nine months ended September 30, 2019 – Cost-Shared Mandatory Programs
- Appendix “2” – Q3 Financial Report 2019: All Other Programs
- Appendix “3” – Q3 Financial Report 2019: 100% MOH Funded One-Time Grants
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. Prepared by: Rob Cunnington, CPA CA Manager, Finance Reviewed by: David Kingma, Director - Administration Approved by: Dr. Nicola Mercer, Medical Officer of Health & CEO (Original Signed Document on File
Wellington-Dufferin-Guelph Public Health
Statement of Revenue and Expenditures
Total Cost-Shared Mandatory Programs
For the Quarter ended September 30, 2019
|Annual Budget 2019 ($)||YTD Budget 2019 ($)||YTD Actual (2019 $)||YTD Variance (Variance* $)||YTD Variance%)|
Municipal and provincial funding
|MOHLTC - Base funding||12,345,700||9,259,275||9,259,273||(2)||0.0%|
|City of Guelph||3,912,072||2,934,054||2,934,054||0||0.0%|
|County of Wellington||2,700,442||2,025,332||2,025,331||(1)||0.0%|
|County of Dufferin||1,827,476||1,370,607||1,370,607||(0)||0.0%|
|Transfers from reserve||22,333||16,749||0||(16,749)||-100.0%|
|Employee salaries, wages and benefits||15,719,589||11,534,945||11,356,233||178,712||1.5%|
|Board/volunteer training and recognition||38,500||24,560||9,271||15,289||62.3%|
|Office expenses, printing, postage||175,323||131,760||92,782||38,978||29.6%|
|Professional and purchased services||775,793||600,417||375,352||225,064||37.5%|
|Program materials and supplies||496,000||368,592||378,867||(10,275)||-2.8%|
|Information and IT equipment||781,949||675,500||833,372||(157,872)||-23.4%|
|Transfers to Reserve Funds||384,727||384,727||384,727||0||0.0%|
Total net operating costs
Total net expenditures after expenditure recoveries
Excess of revenue over expenditures
* Variances greater than $100,000 are explained in the body of the accompanying report.
Wellington-Dufferin-Guelph Public Health
Q3 Financial Report 2019
All Other Programs (Fund category 2 through 14)
|Program/Initiative Name||Provincial/ Municipal Split||Fiscal Year-end||Provincial Funding Requested||Municipal Funding Approved||”Other” Funding Approved||Total Program/ Initiative Budget||Funding Received to Date||Expenditures Incurred to Date||Excess (Deficiency) of Funding over Expenditures||Expected Surplus (Deficit) at Year-End|
|Vector-Borne Diseases (2)||Cost-Shared||December 31st||150,700||58,917||209,617||157,213||118,507||38,706||0|
|Small Drinking Water Systems (2)||Cost-Shared||December 31st||40,600||15,040||55,640||41,734||40,881||853||0|
|Needle Exchange (3)||100% Provincial||December 31st||61,000||61,000||45,750||47,651||(1,901)||0|
|Enhanced Food Safety (3)||100% Provincial||December 31st||40,300||40,300||30,225||29,888||337||0|
|Healthy Smiles Ontario (3)||100% Provincial||December 31st||817,400||817,400||613,046||561,845||51,201||0|
|Infection Control (3)||100% Provincial||December 31st||333,400||333,400||250,054||244,186||5,868||0|
|Smoke Free Ontario (3)||100% Provincial||December 31st||409,500||409,500||307,119||291,403||15,716||0|
|Electronic Cigarettes Act (3)||100% Provincial||December 31st||19,200||19,200||14,400||4,709||9,691||0|
|Harm Reduction Program Enhancement (3)||100% Provincial||December 31st||150,000||150,000||112,500||109,755||2,745||0|
|Enhanced Safe Water (3)||100% Provincial||December 31st||21,600||21,600||16,200||12,137||4,063||0|
|Chief Nursing Officer (3)||100% Provincial||December 31st||121,500||121,500||91,131||88,903||2,228||0|
|Infection Prevention and Control Nurse (3)||100% Provincial||December 31st||90,100||90,100||67,573||66,201||1,372||0|
|Social Determinants of Health Nurses (3)||100% Provincial||December 31st||180,500||180,500||135,377||132,622||2,755||0|
|MOH Compensation (3)||100% Provincial||December 31st||83,710||83,505||62,969||60,722||2,247||0|
|Healthy Babies Healthy Children (4)||100% Provincial||March 31st||1,567,992||1,567,992||1,175,994||1,131,838||44,156||0|
|Preschool Speech and Language (5)||100% Provincial||March 31st||1,013,216||61,283||1,074,499||568,820||543,582||25,238||0|
|County of Wellington Weetalk (6)||100% Municipal||December 31st||367,921||367,921||275,941||266,395||9,546||0|
|Canadian Prenatal Nutrition Program (7)||100% PHAC||March 31st||63,410||63,410||30,283||22,030||8,253||0|
|External Projects* (8, 9, 10, 11, 12,13,14)||Various funders*||March 31st / December 31st||168,100||334,274||502,374||340,964||213,171||127,793||0|
|Ontario Seniors’ Dental Care Program (3)||100% Provincial||December 31st||651,825||651,825||0||72,128||(72,128)||0|
Wellington-Dufferin-Guelph Public Health
Q3 Financial Report 2019
100% MOHLTC Funded One-Time Grants (15)
|Name of Grant||Budget Year of Request||Fiscal Period for Eligible Expenditures||Approved 2018 Provincial One-Time Funding deferred for use up to March 31, 2019||Approved 2019 Provincial One-Time Funding deferred for use up to March 31, 2020||Total Expenditures 2019||Balance Re-payable to MOHTLC|
|Enterprise Resource Planning Software Procurement||2018||April 1, 2018 to March 31, 2019||19,390||19,390||-|
|Adverse Childhood Experiences Survey||2018||April 1, 2018 to March 31, 2019||406||-||406|
|Preconception Health Risk Assessment||2018||April 1, 2018 to March 31, 2019||9,744||9,744|
|Vision Screening||2018||April 1, 2018 to March 31, 2019||72,199||72,199|
|Public Health Inspector Practicum Program||2019||April 1, 2019 to March 31, 2020||10,000||10,000|
|New Purpose-Built Vaccine Refrigerators||2019||April 1, 2019 to March 31, 2020||11,000||10,363||637|