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 :
Esther Moghadam, Manager/Gestionnaire
Integration Quality and Standards/Intégration, Qualité
et Normes
Ottawa Public Health/Santé
publique Ottawa
613-580-2424, ext./poste 23789 esther.moghadam@ottawa.ca
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ACS2011-OPH-IQS-0009 |
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SUBJECT: |
PUBLIC HEALTH
ACCOUNTABILITY AGREEMENT |
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OBJET : |
ENTENTE DE RESPONSABILITÉ DE LA SANTÉ PUBLIQUE |
REPORT
RECOMMENDATIONS
That the Board of Health for the City of Ottawa Health Unit receive
this report for information.
RECOMMANDATIONS DU RAPPORT
Que le Conseil de santé de la circonscription
sanitaire de la ville d’Ottawa prenne connaissance du présent rapport à titre
d’information
BACKGROUND
Earlier this year, the Ministry of Health and Long-term Care (MOHLTC) and the Ministry of
Health Promotion and Sport (MHPS) replaced the current Program Based Grants
Terms and Conditions, which comprised the legal agreement under which boards of
health received provincial funding, with the Public Health Accountability Agreement
(PHAA).
The purpose of the PHAA, as stated by the MOHLTC, is to “improve and strengthen the Province’s ability to effectively analyze the Board of Health’s expenditures and ensure accountability for the use of the Grant.” The PHAA confirms the Ministries and Ottawa Board of Health’s responsibilities associated with the Health Protection and Promotion Act (section 76), which outlines expectations on the delivery of programs and services that meet the Ontario Public Health Standards, and other requirements of the Act. All boards of health are required to sign the PHAA, as a framework for establishing policies, and procedures regarding funding as well as setting out expectations regarding performance reporting.
The PHAA is a multi-year provincial transfer payment agreement which sets out obligations of the Board of Health and the MOHLTC and MHPS for the period of January 1, 2011 – December 31, 2013. Similar to other funding-based agreements, the PHAA outlines Ottawa Board of Health’s:
·
Fiscal accountability;
·
Reporting requirements;
·
Performance obligations; and
·
Approved provincial funding.
As the MOHLTC
and MHPS have assumed a greater role in funding boards of health, the PHAA is a
natural progression in this funding relationship. Further, the requirements
outlined in the PHAA build on public health’s work towards increased
accountability and revitalizing Ontario’s public health system. The data
collected as a fulfilment of the PHAA will provide provincial-level
measures that will be used to draw comparisons across public health units,
develop benchmarks, as well as provide information about the contributions of
public health at the provincial level. In addition, the data will also assist the Ministries in
planning future programming and strategic policy initiatives.
Consultation on the PHAA draft
performance indicators
In May 2011, the MOHLTC and MHPS invited representatives from all boards of health to participate in a consultation process on the proposed PHAA draft performance indicators. OPH staff completed the consultation survey and provided Board members with draft responses for their input. Feedback received from Board of Health members was provided to the Ministry. In addition, staff consulted with the City of Ottawa’s legal counsel and financial services about the implications of funding agreements. OPH staff also conducted a technical review of the Ministries’ proposed indicators as compared to data currently collected by OPH.
DISCUSSION
2011 Accountability Agreement
The 2011
Accountability Agreement includes five parts:
1. Terms
and conditions of the funding relationship;
2. List
of 2011 approved program based grants (Schedule A);
3. Policies
and guidelines associated with provincial base funding, one time funding, and
other funding (Schedule B);
4. Board
of Health ongoing and one-time reporting requirements (Schedule C); and
5. Board
of Health performance obligations and indicators (Schedule D).
Board of Health
Reporting Requirements (Schedule C)
Reporting requirements for the Board of Health are
outlined in Schedule C in the PHAA. These reporting requirements include:
·
Quarterly financial
reports;
·
An annual
financial report;
·
A report on all
one-time funded projects;
·
Implementation
plans, activity plans, and status update for specific mandated programs; and
·
Information on
program specific budgets, and grants applications.
Board of Health performance indicators (Schedule
D)
There are
14 performance indicators that are program specific. These indicators will be
used to align program specific funding allocation with performance measures. This
is the first time Boards of Health have been required to sign an agreement that
includes performance measures associated with a funding allocation, although
frameworks for reporting have been developed by the MOHLTC in the past. In the
near future, performance targets for 2012 and 2013 will be developed.
Ottawa Public Health’s Capacity to Complete
PHAA Reporting Requirements
Overall OPH is in a good position to respond to the PHAA reporting requirements. OPH currently tracks or has the ability to track all 14 Board of Health performance indicators. In addition, as part of reporting to the Board of Health, OPH currently works with Financial Services to generate quarterly and annual financial reports. Finally, OPH staff responsible for the new program initiatives will ensure timely reporting to the MOHLTC.
City of Ottawa Legal Comment
As
previously mentioned, the City
of Ottawa’s legal counsel commented on
the draft Public Health Accountability Agreement that was circulated
to all boards of health as part of the Ministry's May 2011 consultation
process.
At that time, Legal recommended that the wording
in sections 2.3 (b) to (i) and 2.4 be revised or removed from
the Agreement, given it is broad and lacking in particulars,
therefore it is open to subjective interpretation. However, these clauses
remained unchanged in the final form of the August 2011
Agreement that OPH received from the Ministry.
In response to Legal's concerns about broad
the wording in sections 2.3 (b) to (i) and 2.4, on
August 31, 2011, MOHLTC staff advised that "It is important to note that
the board of health has a responsibility to ensure that it can carry out its
obligations under the agreement within its own unique administrative and
accountability structure, and accordingly the board of health should be in the
best position to determine what sorts of procedures will best allow it to
comply with its obligations under the agreement"
Accordingly, legal staff has suggested that
additional wording be inserted into section 2.4 of the Agreement
as follows: "The
Ministry acknowledges and agrees that the Board has its own unique
administrative and accountability structure so that the Board is in
the best position to determine the procedures that will best allow it to
comply with its obligations under this Agreement."
The City of Ottawa’s legal recommendations for the PHAA are
subject to review and approval by the MOHLTC.
The MOHLTC surveyed health units including board members in May 2011
regarding the proposed Accountability Agreement.
There
are no legal implications related to this report
FINANCIAL IMPLICATIONS
There are no financial implications with the approval
of the recommendations in this report.
Document 1- Public
Health Accountability Agreement 2011 (kept on file with the Board Secretary)
Ottawa Public Health
staff will ensure the Ottawa Board of Health is able to fulfill its obligations
as outlined in the Public Health Accountability Agreement. Ottawa Public Health
staff will facilitate Chair Holmes to sign the Agreement on behalf of the
Ottawa Board of Health and send the signed Agreement to the MOHLTC.