Infectious Diseases Control Initiative – this funding pays for 2.0 FTE Public Health Nurses and 1.0 FTE Epidemiologist, as well as some travel and equipment costs. The 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 Finance Committee Report BH.04.SEP1516.R11
September 15, 2016
Report to: Finance Committee, Board of Health
Submitted by: Elizabeth Bowden, Interim Director of Administrative Services
Subject: 2016 SECOND QUARTER FINANCIALS
Recommendations
(a) That the Finance Committee makes recommendation to the Board of Health to receive the 2016 Second 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 Public Health in the community. These community grants are numbered (8) through (12) below.
| No. | Program/Budget Name | Funder(s) | Year-end |
|---|---|---|---|
| Cost-Shared Sub-budgets | |||
| 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 |
| 100% Funded Sub-budgets | |||
| 3 | 100% MOHLTC Funded Programs | Ministry of Health and Long-Term Care | December 31st |
| 4 | Healthy Babies Healthy Children (HBHC) | Ministry of Children and Youth Services | December 31st |
| 5 | Preschool Speech and Language (PSL) | Ministry of Children and Youth Services | March 31st |
| 6 | Wee-Talk | County of Wellington | December 31st |
| 7 | Canadian Prenatal Nutrition Program (CPNP) | Public Health Agency of Canada | March 31st |
| Other Community Grants | |||
| 8 | Poverty Elimination Task Force (PETF) | City of Guelph, County of Wellington, United Way Wellington-Dufferin-Guelph | December 31st |
| 9 | Children’s Report Card | County of Wellington, Dufferin Coalition for Kids (DuCK), Dufferin Child & Family Services (DCAF) | December 31st |
| 10 | Nurturing Neighbourhoods Family and Children’s Services | Guelph-Wellington | December 31st |
| 11 | My Health e-Snapshot: A Preconception Health Research Study | Women’s College Hospital | December 31st |
| 12 | System of Care | County of Wellington, KidsAbility, CMHA WaterlooWellington | December 31st |
The 2016 budget approved by the Board of Health on October 7, 2015 only included sub-budgets (1), (2), and (3) above. These sub-budgets were submitted to the MOHLTC via the Program Based Grants (PBG) submission on March 1, 2016. Total budgeted revenue and expenses for all of the Cost-Shared Mandatory, Cost-Shared Related (Vector-Borne Diseases and Small Drinking Water Systems), and 100% MOHLTC Funded budgets are below:
| No. | Name of Budget | BOH Approved | 2015 One Time Grants Deferred | Total 2016 Budget |
|---|---|---|---|---|
| 1 | Cost-Shared Mandatory | $20,223,271 | $319,216 | $20,542,487 |
| 2 | Vector-Borne Diseases | $206,221 | $206,221 | |
| 2 | Small Drinking Water Systems | $54,772 | $54,772 |
| Name of Budget | Funding Requested | |
|---|---|---|
| 3 | Needle Exchange | $50,000 |
| 3 | Enhanced Food Safety | $40,300 |
| 3 | Healthy Smiles Ontario | Not included in submission |
| 3 | Infection Control | $333,400 |
| 3 | Smoke Free Ontario | $409,500 |
| 3 | Electronic Cigarettes Act | $19,200 |
| 3 | Enhanced Safe Water | $21,600 |
| 3 | Chief Nursing Officer | $121,500 |
| 3 | Infection Control Nurses Initiative | $90,100 |
| 3 | Social Determinants of Health Nurses | $180,500 |
| 3 | MOH Compensation | $83,714 |
In addition to the MOHLTC and municipal funding, WDGPH will receive funding for 2016 for the following programs/projects:
| Program/Project | Funding | |
|---|---|---|
| 4 | Healthy Babies Healthy Children | $1,567,992 |
| 5 | Preschool Speech and Language | $808,573 |
| 6 | Wee-Talk | $367,921 |
| 7 | Canadian Prenatal Nutrition Program | $63,410 |
| 8 | Poverty Elimination Task Force | $130,841 |
| 9 | Children’s Report Card | $113,000 |
| 10 | Nurturing Neighbourhoods | $40,125 |
| 11 | My Health eSnapshot: A Preconception Health Research Study | $15,000 |
| 12 | System of Care | $46,829 |
In addition to the above funding, the following one-time grant requests were submitted to MOHLTC for 2016:
| 2016 One-Time Grant Requests (Cost-Shared) | |
|---|---|
| Name of Grant | Provincial Funding Requested |
| Positive Space Training | $15,000 |
| Website | $200,000 |
| Psychological Health & Safety in the Workplace | $15,000 |
| Dental Clinic Equipment | $34,230 |
| ERP Consultant | $75,000 |
| Oral Health Practice Management Software | $25,000 |
| 2016 One-Time Grant Requests (100% MOHLTC Funded) | |
|---|---|
| Name of Grant | Provincial Funding Requested |
| Immunization of School Pupils Act Regulatory Amendments Implementation | $60,681 |
| PHI Practicum | $10,000 |
| Additional Parking Spaces | $250,000 |
| Health Protection Tablets | $74,800 |
| New Shelburne Location Renovations* | $400,000 |
| * withdrawn | |
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 boards of health are required provide to the communities they serve in accordance with the Health Protection and Promotion Act (HPPA), Ontario Public Health Standards (OPHS) and the Organizational Standards. MOHLTC funding for mandatory programs is provided on a global basis (as opposed to a line by line basis), and boards of health are responsible for allocating the funding to meet the requirements of the HPPA, OPHS, and Organizational Standards according to local needs and priorities.
Current Net Position:
Appendix “1” represents the statement of revenue and expenditures for the six months ended June 30, 2016, for the Cost-shared Mandatory programs. As reported on the attached statement, there was a net excess of revenue over expenditures of $1,084,027 for the first six months of the year. Budget to actual variances of greater than $100,000 are explained below:
Salary and benefits expenses had a positive variance of $623,208 for the first six months as a result of two vacant Director positions (one of which has subsequently been filled), one vacant management position (temporarily backfilled), maternity leaves, a leave of absence, and temporary and casual staff who have a two week payroll lag.
Building Occupancy expenses had a positive variance of $227,146 for the first six months of the year as a result of lower than budgeted hydro costs for the Chancellors Way office and several maintenance projects which are underway and which will be completed in the third and fourth quarters.
Information and IT Equipment expenses had a positive variance of $109,228 as planned annual computer hardware purchases were made in the third quarter, and computer software licensing fees are incurred later in the year.
Appendix 2: All Other Programs (2 – 12)
Appendix Two presents the Funding and Expenditures for the first six months of the year for the Cost-Shared Related (Small Drinking Water Systems and Vector-Borne Diseases) and 100% funded programs.
Ministry of Health and Long-Term Care 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
Ministry of Health and Long-Term Care 100% Funded 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 In 2015, there was $9,994 more spent than was provided in provincial funding. Municipal funding was used to cover the shortfall. The 2016 provincial funding request is $50,000.
Enhanced Food Safety – this initiative was established to augment the Board of Health’s capacity to deliver the Food Safety Program.1 This funding pays for 0.35 FTE of a Public Health Inspector, and some program supplies costs and training.
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 This program has been merged with the CINOT and CINOT Expansion programs effective January 2016, with the merged program currently being referred to as HSO II by the Ministry. The funding envelope for this program has not yet been provided by the Ministry. Public Health Units were not asked to submit a budget request for this program with the PBG submission which was due in early March 2016.
Infectious Diseases Control Initiative – this funding pays for 2.0 FTE Public Health Nurses and 1.0 FTE Epidemiologist, as well as some travel and equipment costs. The 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 This funding pays for 0.15 FTE of a Public Health Inspector, as well as some program supplies and training.
Chief Nursing Officer – funding provided for the Chief Nursing Officer position at the Health Unit. The purpose of the Chief Nursing Officer in the 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 pays for 1.0 FTE Public Health Nurse. The majority of the Infection Prevention and Control Nurse’s time must be spent on infection prevention and control activities.1
Social Determinants of Health Nurses Initiative – this funding pays for 2.0 FTE Public Health Nurses. 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 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
Ministry of Children and Youth Services Funded Programs
Healthy Babies Healthy Children – under this program 8.2 FTE Public Health Nurses, 5.8 FTE Family Home Visitors, 1.0 Data Entry Clerk, and 1.0 Program Assistant are funded to help 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 – this funding pays for 2.0 FTE Speech Language Pathologists and 0.6 of a FTE Wee Talk Administrator employed by WDGPH, and approximately 4 Speech Language Pathologists employed by Groves Memorial Hospital, Fergus, St. Joseph’s Healthcare, Guelph, and Headwaters Hospital, Orangeville. Together with the three hospitals, WDGPH coordinates the provision of speech pathology services in the Counties of Wellington and Dufferin, and the City of Guelph. 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 Ministry of Children and Youth Services under the Preschool Speech and Language program.
Canadian Prenatal Nutrition Program - this funding is provided by the Public Health Agency of Canada 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 three municipalities served by WDGPH, and other community partners (Family and Children’s Services and United Way). The work undertaken with this funding falls within 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.
Appendices
Appendix “1” - Statement of Revenue & Expenditures for the six months ended June 30, 2016 – Cost Shared Mandatory Programs
Appendix “2” – Q2 Financial Report 2016: All Other Programs
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 and Youth 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: Shanna O’Dwyer Manager, Finance
Reviewed by: Elizabeth Bowden, Interim Director, Administrative Services
Approved by: Dr. Nicola Mercer, Medical Officer of Health & CEO
