May 2019 Board Meeting - Q1 Financial Results Information Report

Prepared By:

Lorie Gregg, Director of Corporate Services

Date:

May 1, 2019

Subject:

Background

The Leadership Team of the Windsor-Essex County Health Unit (“the WECHU”) monitors financial results on an on-going basis for the following programs:

• Mandatory programs funded to a maximum of 70% (prior to April 1, 2019, 75%) (“Cost-Shared”) by the Ministry of Health and Long-Term Care (“MOHLTC”) and 30% (prior to April 1, 2019, 25%) by  the Corporation of the City of Windsor, the Corporation of the County of Essex and the Corporation of the Township of Pelee (hereinafter referred to as the “Obligated Municipalities”);
• Related programs such as Vector-Borne Diseases and Small Drinking Water Systems, funded on a cost-shared basis to a maximum of 70% (prior to April 1, 2019, 75%) by the MOHLTC and 30% (prior to April 1, 2019, 25%) certain surrounding municipalities within the geographic boundaries of Windsor and Essex County;
• Related programs funded 75% (prior to April 1, 2019, 100%) by the MOHLTC and 30% (prior to April 1, 2019, nil%) by the Obligated Municipalities;
• Related programs funded 100% by the Ministry of Children, Community and Social Services (“MCSS”).  As at the date of this report, there have been no changes to the funding model.
• One-time business cases.  As at the date of this report, the MOHLTC has not communicated what changes, if any, will occur with the funding of these initiatives.

The first quarter financial report to the Board includes a budget to actual comparison and narrative for material variances for all programs listed above.

Cost-Shared Program Financial Results

The following is the financial information for the Cost-shared programs including Vector-Borne Diseases and Small Drinking Water Systems for the first quarter of 2019.

For the period January 1, 2019 to March 31, 2019, cash flows relating to the 2019 program year are as follows:

Material variances by financial caption compared to budget include the following:

• Association and Membership Fees:  Expenditures in this financial caption relate to memberships in an association or other group by virtue of professional requirements or to support initiatives associated with Public Health.  The majority of Association and Membership Fees are paid in the first half of the fiscal year.  The WECHU anticipates that this financial statement caption will remain within its overall budget for fiscal 2019.
• Program Supplies:   Expenditures in this financial caption support the functions of departments, those that directly support Public Health Programs as well as those that support departments such as Information Technology and Communications.  The variance in the Program Supplies caption relates to the timing of purchases and is nominal.  The WECHU anticipates that this financial caption will remain within its overall budget for fiscal 2019.
• Professional fees:  Expenditures in this financial caption include legal, audit and consulting fees paid to third parties.  The budget variance in Professional fees relates to an increase in legal costs to support the current collective bargaining with the employees represented by the Ontario Nurses Association (“ONA”).
• Bank charges:  Expenditures in this financial caption include processing fees associated with payroll.  The variance in this financial caption is due to additional costs incurred for processing of year-end payroll reporting (i.e. T4 slips).
• Building Maintenance:  Expenditures in this financial caption include costs to maintain Windsor, Essex and Leamington locations.  More specifically, these costs relate to building and equipment maintenance, grounds keeping and housekeeping supplies.  The variance here relates primarily to grounds keeping costs.  These costs are incurred in five (5) of twelve (12) months of the fiscal year (January to March, November and December). Greater than one-half of the year’s grounds budget was expended in Q1 of 2019 ($7,440 of the total $12,300).
• Taxes:  Expenditures in this financial caption include property taxes for the Windsor and Leamington offices.  Windsor property taxes are paid on an installment basis, six (6) times per year while Leamington taxes are paid monthly.  The year-to-date variance/overspend results from three (3) of the six installments for the Windsor office having been paid in Q1 and three (3) of the twelve installments having been paid for the Leamington office.
• Insurance:  Expenditures in this financial caption include costs associated with general liability insurance, property insurance, director and office insurance coverage as well as cyber coverage.   Insurance premiums are paid at the beginning of the year.  The WECHU that the budget for this financial statement caption will remain slightly underspent for fiscal 2019.
• Security:  Expenditures in this financial caption include security costs contracted on an as needed basis for after-hours events at our Windsor office location.  The WECHU incurred additional security costs for the period March 8, 2019 to March 31, 2019, due to the labour disruption.  These additional security costs will be reflected in the Q2 financial results.
• Offset revenue:  Revenues included in the financial caption relate to interest, proceeds on sale of tangible capital assets, parking revenue, vaccine recoveries, sales of contraceptives as well as course fees relating to the food handler course and examination.  At March 31, 2019, offset revenue is under budget by $15,121, in part due to the timing (i.e. vaccine recoveries are higher in the latter part of the year) as well as a loss in parking revenue of $4,000 due to the labour disruption.

Healthy Babies Healthy Children Program Financial Results

The Healthy Babies/Healthy Children Program is funded through the Ministry of Children, Community and Social Services.  This program supports 27.0 FTEs comprised of managers (2), nurses (17), family home visitors (4), social worker (1), and support staff (3).  The objective of the program is to ensure a healthy future for children and their families. 

For the first quarter of 2019, the HBHC program is $152,761 underspent.  Factors contributing to the total amount underspent at March 31, 2019 include:  1.  Labour disruption involving employees represented by the ONA which commenced March 8th, 2019;  2.  Lower than anticipated purchased services costs (i.e. translation) because of our use of an Arabic speaking nurse to address the needs of our community.

Nurse Practitioner Programs

The Nurse Practitioner Program is funded through the Ministry of Children, Community and Social Services.  This program supports 1 FTE (nurse practitioner).  The objectives of the program are to promote healthy pregnancy, birth and infancy for children, improve parenting and family supports, strengthen early childhood development, learning and care.

The budget variance of $9,387 due to the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019.

Financial Information for Related Programs Funded 100% by the MOHLTC

The Healthy Smiles Ontario Program is funded through the Ministry of Health and Long-Term Care.  This program supports 14.25 FTEs comprised of a manager (0.75), dental assistants (5.5), dental hygienists (5.5), a health promotion specialist (0.5), and support staff (2).  This program provides preventative, routine, and emergency and essential dental treatment for children and youth, from low-income families, who are 17 years of age or under

At March 31, 2019, the HSO budget is underspent $21,303.  Primarily, this variance relates to Purchased Services, which includes professional services provided by dentists as well as translation.  In Q1 of 2019, there were fewer available dentists hours in the months of February and March.  Subsequent to March 31, 2019, additional dentists hours are available and it is anticipated that the Purchased Services budget will trend to be on budget for the remainder of the fiscal year.

Enclosed above is the financial information associated with the WECHU’s requirements to:

• Comply and adhere to the Electronic Cigarettes Act:  Public Health Unit Guidelines and Directives: Enforcement of the Electronic Cigarettes Act;
• Comply and adhere to the Smoke-Free Ontario Strategy:  Public Health Unit Tobacco Control Program Guidelines and the Directives:  Enforcement of the Smoke-Free Ontario Act. 

At March 31, 2019, total expenditures are under budget $708.  Salaries and benefits remain overspent for Q1 due to the addition of one contract Tobacco Enforcement Office to December of 2019, to assist with the increasing demand for enforcement activities due to the legalization of cannabis. 

A description of other related programs is included below:

Chief Nursing Officer Initiative:  Under the Organizational Requirements of the Ontario Public Health Standards, the Chief Nursing Officer role serves to enhance health outcomes of the community at individual, group and population levels:  i) Through contributions to organizational strategic planning and decision making; ii) By facilitating recruitment and retention of qualified, competent public health nursing staff; iii) By enabling quality public health nursing practice.  This funding envelope supports 1 FTE meeting certain qualifications as required by the Ontario Public Health Standards.  At March 31, 2019, there are no negative variances to report on.

Enhanced Food Safety – Haines Initiative:  This initiative was established to enhance the Board of Health’s capacity to deliver the Food Safety Program as a result of the Provincial Government’s response to Justice Haines’ recommendations in his report “Farm to Fork:  A Strategy for Meat Safety in Ontario”.  At March 31, 2019, there are no negative variances to report on. 

Enhanced Safe Water:  This initiative was established to enhanced the Board of Health’s capacity to meet the requirements of the Safe Water Program Standard under the Ontario Public Health Standards.  At March 31, 2019, there are no negative variances to report on.

Harm Reduction Program Enhancement:  Base funding for this initiative supports the Board of Health’s in the activities associated with its Local Opioid Strategy.  More specifically it supports 2.5 FTEs dedicated to working on activities associated with:  i) Our local opioid response; ii) Naloxone Distribution and Training;  iii)  Opioid Overdose Early Warning and Surveillance.   At March 31, 2019, the budget for this program initiative is underspent by $8,041 due to the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019 as well as other staff vacancies.

Infection Prevention Control Nurses Initiative:  This initiative was established to support one additional infection prevention and control nursing FTE having certain qualifications.  At March 31, 2019, the budget for this program initiative is underspent by $19,925 due to an unpaid absence as well as the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019.

Infectious Disease Control Initiative:  This initiative was established to support the hiring of infectious diseases control positions (4.5 FTEs) and supporting these staff to monitor and control infectious diseases.  They serve to enhance the Board of Health’s ability to handle and coordinate increased activities related to outbreak management.  At March 31, 2019, the budget for this program initiative is underspent by $3,970 due to the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019.

Needle Exchange Program Initiative:  This initiative was established to support the purchase of needles and syringes, and their associated disposal costs, for the Board of Health’s Needle Exchange Program.  At March 31, 2019, there are no negative variances to report on.

Social Determinants of Health Nurses Initiative:  This initiative was established to support 2 public health nursing FTEs with specific knowledge and expertise in social determinants of health and health inequities issues, and to 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.  At March 31, 2019, the budget for this program initiative is underspent by $15,495 due to the labour disruption involving employees represented by the ONA, which commenced March 8th, 2019.

Financial Information for Related Programs Funded 100% by the MOHLTC

Mandatory Programs - Potassium Iodide Distribution Program:  One-time funding to improve nuclear emergency preparedness and increase knowledge amongst residents living within the primary and secondary zone of the Fermi 2 nuclear generating station.  Eligible costs include potassium iodide pill packs, staff salaries, project materials, printing and postage associated with the distribution of KI packs and on-going communication campaigns.  At March 31, 2019, $134,901 of the total approval of $167,000 was expended. While the WECHU had anticipated that this funding would be expended at March 31, 2019, staff time associated with this project was reallocated to other priorities.

Mandatory Programs - Public Disclosure System:  One-time funding must be used to update software and inspection forms to meet the new disclosure requirements under the Ontario Public Health Standards.   Eligible costs include software update, disclosure and migration.  At March 31, 2019, $10,300 of the funding approval was expended.  Activities related to the implementation of this disclosure system were concluded in February of 2019 and no additional costs are anticipated. 

Capital:  This one-time funding must be used to assist with costs to complete the capital planning requirements for a Stage 2 – Business Case Submission. Utilization of these funds is dependent upon the status of the work being completed internally and by third party consultants based upon the direction from the WECHU’s Board.  At March 31, 2019, $80,057 of the funding approval was expended.  On October 31, 2018, the WECHU submitted a request to extend the deadline to expend funding either to, December 31, 2019, or March 31, 2020.  As at the date of this report, the WECH has not received approval for the funding extension.  Activities related to this initiative are presently on-hold awaiting further direction from the Board and the MOHLTC.

Needle Exchange Program Initiative:  This one-time funding supports extraordinary costs associated with delivering the Needle Exchange Program.  Eligible costs include purchase of needles/syringes and associated disposal costs.  At March 31, 2019, this funding was fully expended.

Public Health Inspector Practicum Program:  This one-time funding supports the hiring of approved Public Health Inspector Practicum positions.  Eligible costs include student salaries, wages and benefits, transportation expenses associated with practicum positions, equipment and educational expenses.  This funding relates to practicum placements for the four-month period, which commenced May of 2018 and concluded in August of 2018.  At March 31, 2019, this funding was fully expended.

Vector-Borne Diseases Program - Enhanced Mosquito Surveillance:  This one-time funding supports an enhanced surveillance program.  Eligible costs include salaries for students, supplies and additional equipment, identification and testing expenses, promotional costs and mileage.  At March 31, 2019, this funding was fully expended.

Approved by:

 Theresa Marentette