M E M O / N O T E D E S E R V I C E

To / Destinataire	Chair and Members of the Corporate Services and Economic Development Committee/ Président et membres du Comité des services organisationnels et du développement économique	File/N° de fichier: ACS2009-CMR-FIN-0023
From / Expéditeur	Marian Simulik	City Treasurer/ Trésorière municipale
Subject / Objet	Capital Funding Support for Long Term Care Facilities/ Soutien du financement des immobilisations pour les installations de soins de longue durée	Date: 26 May 2009May 26th, 2009

This memo addresses Councillor McRae’s question about the funding support the City has provided and could provide to non-profit long term care facilities (LTC) raised at the Corporate Services and Economic Development committee meeting dated March 3^rd, 2009. The question arose during a discussion about capital funding support to hospitals and therefore this review to is limited to capital funding.

Historical Support

The Region established a Health Care/Research Facilities Funding Policy in 1980. The original policy provided:

“The Region’s share shall not exceed the lesser of:

(i) 25% of the capital cost of the project, or

(ii) 37.5% of the Province’s net contribution to the project.”

The policy originally provided for the creation of a Health Care Facilities Reserve Fund to which annual contributions were made based on one-tenth of a mill of the Region’s Equalization Assessment for general purposes. Contributions to this fund terminated in 1989. In 1985 the Region established Development Charges with one of the components of the charge being the costs associated with demands of growth on existing health facilities and on the need for new or expanded facilities. The funds collected for this component of the Regional Development Charge were contributed to a Hospital Regional Development Charge Reserve Fund. The funds from this reserve fund could only be used to fund growth related net capital costs of projects for which development charges had been imposed pursuant to the Regional Development Charges By-law of the time. Contributions to this reserve ended in 1998, when the Development Charges Act (DC Act) was amended such that municipalities could no longer impose such a development charge.

On June 23, 1999, the Regional Council approved the following recommendation from the Corporate Services and Economic Development Committee from the Task Force Report on Regional Government’s Role in Health Care: “THAT in accordance with provincial legislation banning the use of development charges for public hospitals, the remaining balance of $8 million in the Hospital Regional Development Charges Reserve Fund be earmarked for non-hospital health community health services with a priority to those projects that will reduce use of the acute care hospital sector”

The City of Ottawa has provided the following capital grants from the Health Care Facilities / Development Fund reserve accounts for the provision of Long Term Care facilities just prior to amalgamation and since 2000.

	Approval	$ Amount
Capital Grants	Date
Villa Marconi: Purchase of Holy Cross Convent (Facilities Reserve)*	09-Sept-98	1,014,000
Hillel Lodge – Construction of a 100 bed LTC facility (Facilities Reserve)*	09-Sept-98	1,621,590
Osgoode Care Centre: Addition of 30 LTC beds to existing facility (DC)	11-Oct-00	480,000
Villa Marconi: Addition of 64 LTC beds to existing facility (DC)	11-Oct-00	1,024,000
Salvation Army: Construction of 128 bed LTC facility (DC)	11-Oct-00	2,048,000
Monfort Hospital: Construction of 128 bed LTC facility (DC)	11-Oct-00	2,048,000
Royal Ottawa Health Care Group: Construction of 96 bed LTC facility (DC)	10-Oct-01	1,536,000
Glebe Centre: Upgrade existing 195 LTC beds (DC)	8-Jan-03	1,240,000
Island Lodge: addition of 10 LTC beds to existing facility (DC)	8-Jan-03	160,000
Total		$11,171,590

* committed and paid prior to amalgamation

The funds in both the Health Care Facilities / Development Fund reserve accounts funds have been depleted.

Current Provincial capital funding model for LTC facilities

The Province controls the number of approved beds. When the construction of a new facility with additional beds or a redevelopment is approved, the Provincial funding model provides for capital funding on a per bed, per diem basis to be paid over a 20-year period which can be applied to debt to assist in paying the capital cost of the facility. This funding is intended to cover the cost of the facility built to Provincial standards. If the City or private owner decides to build the facility above the Provincial standard then the City or other entity would be responsible to fund the difference.

Current City support provided

Pursuant to paragraph 7(p) of the City’s current DC by-law, non-profit health care facilities may apply to the City for an exemption from paying development charges. This exemption is currently being reviewed as part of the drafting of the 2009 Development Charges by-law.

Conclusion

Additional capital funding for LTC facilities cannot be accommodated with the City’s existing financial resources without impacting taxation or reducing programs elsewhere as there is no dedicated source to contribute towards the capital funding of LTC facilities.

LTC is not a provincially cost-shared program like public health or childcare, however the City is already contributing approximately $8 million annually towards the operating cost of the LTC facilities due to the difficulties of running the program within the provincial standards and funding levels.

Based on these facts, it is not recommended that the City contribute towards the capital costs of LTC facilities beyond what it is currently doing, as this would increase the tax burden in Ottawa.

Marian Simulik

City Treasurer