Report
to/Rapport au :
Ottawa
Board of Health
Conseil de santé d’Ottawa
Monday 19 September 2011/le lundi 19, septembre 2011
Submitted by/Soumis par :
Dr. /Dr Isra Levy,
Medical Officer of Health/Médecin
chef en santé publique
Contact Person/Personne-ressource:
Brian Flynn, Manager / Gestionnaire
Deputy
City Treasurer Controller Branch /
Direction du trésorier municipal adjoint –
Contrôleur
Finance Department / Service des finances
613-580-2424, ext./poste 21839, Brian.Flynn@ottawa.ca
|
ACS2011-OPH-IQS –0010 |
|
SUBJECT: |
DRAFT BOARD OF HEALTH 2012 budget |
|
OBJET
: |
ÉBAUCHE DU
BUDGET 2012 DU CONSEIL DE SANTÉ |
That the Board of Health for the City of Ottawa Health
Unit, for subsequent consideration and
approval at its special meeting on October 17, 2011:
1.
Receive and table the Draft 2012 Ottawa Board of Health Operating
Budget; and
2.
Direct staff to bring forward a report at
its November 19, 2011 meeting to establish a Board of Health Financial
Committee.
Que le Conseil de santé de la circonscription
sanitaire de la Ville d’Ottawa, aux fins d’examen et d’approbation ultérieurs
dans le cadre de sa réunion extraordinaire du 17 octobre 2011 :
1. Reçoive et dépose le Budget de
fonctionnement provisoire 2012 du Conseil de santé d’Ottawa; et
2. Donne pour instruction au personnel, dans
le cadre de sa réunion du 19 novembre 2011, de créer un Comité financier pour
le Conseil de santé.
Background
The Board of Health approved the budget process for the 2012 budget (ACS2011-OPH-IQS-0005) at its August 15, 2011 meeting. This process includes tabling a draft 2012 Ottawa Board of Health budget to the Board on September 19, 2011. Accordingly, Ottawa Public Health (OPH) staff have prepared 2012 draft operating budget estimates in consultation with Financial Department staff, which are within the guidelines provided by the City (ACS2011-CMR-FIN-0029).
Guided by Board of Health’s Strategic Priorities and the Ontario Public Health Standards, the proposed 2012 draft operating budget is designed to enable the Board to support delivery of public health services to Ottawa residents, provide the authority to proceed with key operational programs and projects, address certain priorities, and ensure that the necessary funding is available to develop and implement OPH’s work plan.
With respect to the
City’s budget process, this year, the Board of Health’s budget will first be tabled at the September
19, 2011 Board of Health meeting. As set
out in the 2012 Proposed Budget Process and Timetable report to Council (ACS2011-CMR-FIN-0045), public delegations will be heard at the Board
of Health meeting on October 17, 2011, where the Board will also consider the
budget for approval. The Chair of the
Board will present the budget to Council at its October 26, 2011 meeting. Council will consider the budget
recommendations from all Committees of Council and local boards, including the
Board of Health at its November 30, 2011 meeting
For 2012, OPH is presenting a balanced budget of $52.7M. This proposal assumes a scenario in which pressures relating to population growth are being absorbed, in order to be in accordance with the City of Ottawa’s Long Range Financial Plan IV (part 1) (ACS2011-CMR-FIN-0029), and the anticipated limited revenue increase from the Provincial Government (the Province of Ontario and the City of Ottawa being the two major sources of funding for the Ottawa Board of Health).
DISCUSSION
Delivering on Ottawa
Public Health’s Mandate
The 2011 budget
enabled OPH to successfully deliver a wide variety of needed services to Ottawa
residents. From January 1, 2011 to August 31, 2011, OPH has, for example:
·
Conducted over
20,500 tests for sexually transmitted infections;
·
Screened almost
40,000 children in 200 local schools for dental diseases;
·
Enhanced
suicide prevention services, in partnership with community agencies seeking the
de-escalation of suicide in Ottawa youth;
·
Conducted over
7,600 food safety inspections at more than 5,200 facilities;
·
Responded to more
than 150 community outbreaks in institutions, schools and child care facilities
across Ottawa;
·
Responded to
water emergencies including three boil water advisories which included
community outreach in the affected areas;
·
Responded to approximately 13,000
telephone inquiries on the Ottawa Public Health Information Line;
·
Interacted
with over 1,000 seniors as part of the Aging in Place program; and
·
Expanded its
community reach by growing the Twitter account to over 6,100 followers.
2012
Budget Development Process
Program Priorities
OPH management conducted a comprehensive program review resulting in the development of Program Priorities, related to community needs and growth. The following list identifies 12 Program Priorities as pressures for 2012:
1. Support
to Seniors and Caregivers
·
Enhance service to caregivers and increase their
access to information and support.
·
Provide seniors with oral health, dental screenings
and link seniors in need to dental care services.
·
Establish additional healthy living centres for
seniors, in an effort to engage seniors as peer leaders and participants in
health promotion activity including fall prevention, physical activity, healthy
eating and social supports.
2.
Outbreak Management Strategy
·
Continue implementation of Outbreak
Management Strategy activities in long term care facilities, retirement homes,
child care facilities, schools and with the community at large.
·
Grow service capacity to increase
management of active and latent cases of tuberculosis
3.
Food Vendors and Special Events Licensing and Monitoring
·
Increase outdoor
food vendor and special events
inspections to ensure food safety, health hazards management and respond to
complaints
4.
Personal Service Settings Investigations
·
Increase the frequency of inspections of salons,
tattoo parlours and spas
5.
Social Determinants of Health
·
Assist immigrants in navigating health services
·
Improve health literacy
·
New
Baby Express programming
·
Operate a multi-service vehicle that provides residents
with direct access to public health services such as prenatal, dental health
screenings, sexual health assessment and treatment and immunization
6.
Obesity and Physical Activity
·
Reduce the burden of chronic disease and obesity
·
Develop policies for supportive environments
related to physical activity, and access to healthy foods and beverages
7.
Health Hazards Investigation
·
Maintain environmental policy analysis and
provincial reporting requirements
·
Meet air quality monitoring mandate
8.
Sexual Health Clinic Extension
·
Implement Ottawa Public Health’s three year Sexual
Health Expansion Strategy
9.
Vaccine Inspection and Distribution
·
Increase
outreach activities to expand capacity of community vaccine providers
·
Incorporate new publicly funded vaccines, and evergreen
the publicly funded vaccination schedule
10. IT
planning and infrastructure
·
Implement mobile computing, applications and
licenses, and connectivity plan, which aims to reduce staff need for office
space and mileage charges
11. Community
and School clinics
·
Manage increased costs for medical supplies
·
Establish base funding for nurses administering
vaccines to students in schools
12. Organizational
Performance
·
Implement accountability agreements and completion
of transition to new governance structure
·
Enhance staff development and maintenance of
professional competence
·
Provide business, financial, and
system/applications support for decision making and risk management and ongoing
program operations.
Priority Service Pressures
Following
the comprehensive program review, OPH management assessed budget submissions. The most critical priorities
were determined using the following criteria:
·
Strategic alignment with Board of Health Strategic
Priorities 2011-2014
·
Strategic alignment with City of Ottawa Term of
Council Strategic Priorities
·
Ability to leverage City departmental partnerships
for costing savings
·
Ability to address multiple branch pressures
·
Offset chronic budget pressures
Alignment with City Council Priorities
OPH
management identified three
investment opportunities as the most
critical priorities. These three
investment opportunities align with City Council priority Healthy and Caring
Community Term of Council Priority 1 (HC1). This priority reads: “City of
Ottawa residents enjoy a high quality of life and contribute to community
well-being through healthy, safe, secure, accessible and inclusive places.”
At the Board of Health’s July 11, 2011
meeting, the three investment opportunities were presented in the Ottawa Board of Health’s Strategic Priorities report (ACS2011-OPH-IQS-0003).The
three specific initiatives presented to Council were: Personal Service Setting
Inspection Enhancement, Seniors Community Caregiver Support and new Baby
Express (partnership with Ottawa Public Library). Chair Holmes presented these investment opportunities to City
Council on July 13, 2011.
These investment opportunities offered the Board the ability to address City Council priorities, community needs, and expand on current City of Ottawa partnerships. Unfortunately, OPH is not eligible to receive funding from the City’s strategic initiatives investment envelope, from 2012 to 2014.
Board of
Health’s 2012 investment opportunities
Since July, OPH staff reviewed the budget and the Board’s stated priorities. Staff were able to find solutions that would allow the Board to fund all three investment opportunities. Pending Board approval, OPH is able to address growth and provide new programming in the following areas: Outbreak Management & Public Health Inspection; Support to Seniors and Caregivers
;
and New Baby
Express & Social Determinants of Health. Table 1 outlines these three investment opportunities.
Table1: Proposed OPH 2012
Investment Opportunities
|
Service Pressures |
Program Description
|
|
Outbreak Management & Public Health Inspection $200K |
·
This initiative seeks to increase the
frequency of inspections of outdoor food vendors, including special events,
and high risk personal service settings, such as salons, tattoo parlours and
spas at which an increasing amount and variety of invasive body modification
procedures take place. ·
This initiative would ensure OPH is
able to meet Ontario Public Health Standards and avoid the cost of outbreak
investigations which is resource intensive and time consuming. ·
Funding would be allocated to an
additional Public Health Inspector, and the technological solutions required
for outbreak case management and inspection related programs. |
|
Support to Seniors and Caregivers $147K |
·
The creation of a comprehensive
strategy to increase awareness and access to information and supports
for informal caregivers, such families and friends caring for the
elderly. ·
The initiative will improve access to
services, counselling on healthy aging and building and educating networks of
support for families and friends caring for the elderly in a home setting. ·
The program will increase outreach,
expand access to information modules made available to caregivers via the
web, in workplaces and through health professionals; and improve access to
community resources. |
|
New Baby Express & Social Determinants of Health $145K |
·
This initiative will help reduce
health inequities through cost-effective access and awareness solutions. ·
The initiative is intended to connect
new parents to Public Health Nurses to provide assessment of newborns’ growth
and development, support for breastfeeding, and parenting skills, through library
locations across the City. ·
Public Health Nurses will assist new
parents in navigating health services and improve health literacy. ·
Public Health Nurses will also work
with library staff and volunteers to build on library and OPH prenatal
resources to support the transition to parenthood. ·
Programming delivered in partnership
with Ottawa Public Library. |
Challenges
with 2012 Budget Development
Challenges
OPH is faced with a number of challenges in its mission to deliver needed public health services to Ottawa residents. Population growth, population aging, increased rates of obesity and diabetes, health inequities, injuries, air quality challenges, and emerging infectious diseases are creating significant burden on both human and financial resources. In addition, while new technologies and a mobile workforce are expected to eventually save money through more efficient operations, there are start-up costs associated with implementing these solutions.
The Ministry of Health and Long-term Care has imposed new responsibilities on Ontario’s public health units through the 2011 Ontario Public Health Organizational Standards and new Accountability Agreements. As of 2012, OPH will be required to report on a set of provincial performance indicators that are intended to improve board of health performance and support the achievement of improved health outcomes in Ontario. Unfortunately, the province has not provided an increase in resources to address these responsibilities.
City of
Ottawa Vacancy Allowance Policy - Gapping Target
Each year the City of Ottawa provides departments and some
Boards with a compensation gapping target.
Over the past 5 years OPH’s target has fluctuated, yet has been achieved
in all cases. The gapping target for 2012 is $887K.
Efficiencies (Service Ottawa)
Over the past 5 years, OPH has contributed to the City of Ottawa’s efficiency initiatives with a wide range of productivity savings. In 2011, OPH is projected to achieve its efficiency target of $473K. Looking ahead to 2012, it is anticipated that OPH will continue to participate in the corporate Service Ottawa innovation and internal savings efficiencies exercise. OPH’s efficiency target for 2012 is $517K. These savings are to be primarily achieved through further enabling employees to work in a mobile environment, and through increased use of web-based services. The proposed 2012 budget assumes that OPH will have achieved this efficiency target and re-invest resources identified through efficiency initiatives into priority service pressures.
2011
Baseline Adjustments Explanation
As new funding opportunities are pursued during the year after the budget is approved, budget adjustments are required to add the new revenue and associated expenses. This past year, OPH successfully applied for a number of one time funding grants limited to the 2011 fiscal year. Therefore a subsequent adjustment needs to be made to reflect that the funding will not be carried over into the next budget year. The 2011 baseline adjustment calculation results in a reduction of $1,192K to the 2012 budget.
Considerations
for Future Budget Development
Expansion of Funding
Sources
Given the funding constraints discussed above, and in accordance with the Board of Health Strategic Priorities, staff will initiate development of a multiyear financial strategy and examine broadened potential revenue sources for new programming, including:
In 2012, OPH will examine and expand these alternative funding sources; for example by leveraging the Board of Health’s knowledge of funding opportunities and relationships, and identifying new philanthropic and revenue opportunities.
OPH will also be
reviewing our fees and services as a strategy to increase revenue to offset
program costs where possible.
Long Range Financial Planning for
Ottawa Public Health
OPH has historically
been responsible for short-term budget planning in the context of continually fluctuating
Municipal and Provincial funding environments. However, with the adoption of
the Board of Health Strategic Priorities (2011-2014) (ACS2011-OPH-IQS-0003)
a formal long-range financial plan that
will allow the Board to identify long-term and future service pressures and
execute appropriate financial strategies to re-allocate or seek new funding
sources will be developed.
Upon approval by the
Board, staff will bring forward a report, at the November 21, 2011 meeting
regarding the establishment of a Board of Health Finance Committee. The report will
outline the Committee’s mandate, terms of reference and membership.
OPH
does not currently have a capital budget. Given the new governance structure,
the need to establish a capital budget may also warrant consideration.
NEXT STEPS
Members of the Board can direct questions regarding the Budget to Ms Jane Dare at jane.dare@ottawa.ca or by telephone at 613-580-2424 ext. 12799. OPH will accept public comments on the budget through the Board of Health email account (ottawaboardofhealth@ottawa.ca) or by calling Ottawa Public Health Information Line (613-580-6744; Monday to Friday from 9 am to 4 pm) from September 20, 2011. A summary of comments received will be provided to Board members prior to the Special Meeting of the Board on October 17, 2011, where public consultations will also be received. At this meeting, the Board will discuss and formally approve the Draft 2012 Operating Budget and consider directing staff to bring forward a report to establish a Financial Committee.
Chair Holmes will present the Ottawa Board of Health 2012 Draft Operating
Budget to Council on October 26, 2011. Final budget approval by the City of
Ottawa will take place at a Special Council meeting scheduled for November 30,
2011. The budget will then be presented as a grant request to the relevant
provincial ministries, in accordance with guidelines provided by the
ministries. Provincial decisions regarding revenue flow are generally received
in the summer of the funding year.
The Ottawa Board of Health will consider, for approval, the draft budget at its next meeting on October 17, 2011. Public consultation on the 2012 Ottawa Board of Health draft budget will occur at this meeting.
LEGAL IMPLICATIONS
There are no legal impediments to implementing the recommendations in this report.
FINANCIAL IMPLICATIONS
Financial implications are outlined within the report.
Technology
Implications
The
City of Ottawa’s efficiency initiative may facilitate OPH achieving savings of
$517K in areas such as workforce mobilization activities and through increased
usage of web-based services. These initiatives will require an IT investment from
the City’s Service Ottawa Initiative.
Document 1- Draft 2012 Ottawa
Board of Health Operating Budget
DOCUMENTS À L’APPUI
Document 1- Budget de
fonctionnement provisoire de 2012 du Conseil de santé d’Ottawa
Document 2- Vision, mission, priorités
stratégiques et objectifs du Conseil de santé d’Ottawa pour 2011-2014
The Ottawa Board
of Health will consider, for approval, the
draft budget at its next meeting on
October 17, 2011.