Download MOHLTC Update

Ministry of Health and Long-Term
Care Update
Presentation to alPHa Board of Health General Meeting
October 23, 2009
Allison J. Stuart, Assistant Deputy Minister (A)
Public Health Division
Agenda
1.
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3.
4.
2009 Program Based Grants
Funding Review
Procurement
H1N1
2009 Program-Based Grants
MOHLTC/MHP invested a total $553.0 million for mandatory and related public health
programs and services.
• Mandatory Programs (75%) - $509.3 million
• 5% increase in 2009 included a 3% across-the-board increase for common cost drivers
to all public health units, 1% for population growth and 1% for low income populations.
• Related Programs: $43.7 million
• Infectious Diseases Control (100%) - $18.7 million
• Infection Prevention and Control Nurses (100%) - $2.9 million
• Public Health Research, Education and Development - $1.8 million
• Small Drinking Water Systems (100%) – $4.1 million
• Unorganized Territories (100%) - $4.8 million
• Vector-Borne Diseases (75%) - $8.6 million
• Other Program Grants (including one-time grants) - $2.8 million
• Since 2003, funding has more than doubled, including both uploaded costs and increased
investments in public health capacity.
• 110.6% increase ($290.3 million), of which 52.4% ($152.2 million) is due to upload and
47.6% ($138.1 million) is due to growth.
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Summary of Approved Funding
Mandatory and Related Programs
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MOHLTC Investment in Public Health 2003 - 2009
Related Programs
600.0
43.7
Mandatory Programs
44.4
500.0
42.7
Provincial Cost Share
of
Mandatory Programs
40.3
400.0
41.3
$M 300.0
27.7
39.8
459.9
484.8
509.3
379.7
200.0
303.8
234.9
252.3
100.0
0.0
262.6
2003
292.1
2004
345.1
420.0
502.6
529.2
553.0
2005
2006
2007
2008
2009
Year
2003
2004
2005
2006
2007
2008
2009
Provincial Share
50%
50%
55%
65%
75%
75%
75%
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Funding Review - Overview
• The Public Health Division is at the very early stages of developing a
process and proposal for reviewing the provincial funding provided to public
health units.
• The funding review is expected to take a holistic approach to public health
unit funding and will examine the funding for mandatory and related
programs (i.e., Unorganized Territories, Vaccination Subsidies, Infectious
Diseases Control, and Capital).
• This review, which will examine a number of funding models and options,
will take some time and the process will include stakeholder engagement.
Funding Review – Setting the Stage
• Inequities in all likelihood exist due to historical funding patterns and are
maintained through across-the-board increases
• Economic climate
• No new funding is available as a consequence of this review
• No confirmation that increases available in recent years will continue in the
future
• Other considerations
• Changing demographics
• Capital – recognition within MOHLTC of need for process to address
• Performance Management Framework
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Funding Review – Next Steps
• Verify historical data
• Confirm scope of the funding review
• e.g. MOHLTC funded programs, all funded programs, or a combination
• Identify cost pressures through information gathering
• salaries and benefits, capital issues, information technology, funding challenges in
mandated programs, revenue
• Charge-Backs
• Identify potential models for funding, cost reductions, risk/impact analysis and
implementation approaches
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Procurement
• The new Procurement Directive is available on the Ministry of Government
Services (MGS) website and includes changes related to the use of noncompetitive procurement processes for consulting services and procurement
approval authorities; changes have also been made to directives related to
travel, meal and hospitality expenses.
• A risk assessment of autonomous health units’ purchasing practices took
place in August to assess their purchasing approval authority framework;
procurement planning as an integral part of purchasing policy; and use of
competitive processes when purchasing consulting services.
• Public health units are not required to comply with the government’s new
Procurement Directive. However, as public health units receive substantial
funding from the province, best practice and fiscal prudence would align the
public health units’ procurement policies with the new procurement directive
and with that of the relevant municipality as appropriate.
H1N1 Planning
Current Status – What we Know
• pH1N1 is currently the predominant circulating influenza virus
• Most illness has been mild, with low rates of hospitalizations and deaths
• Ontario is no longer reporting case –level information: little utility once influenza is established
in the community
- Community activity levels for influenza-like illness available at www.ontario.ca/flu
(Ontario Influenza Bulletin)
• Severe disease causing hospitalization occurs most frequently in children and young adults
• Risk factors for severe outcomes also include chronic medical conditions; people over 65;
children under 5; pregnant women; people living in remote/isolated communities; residents of
long-term care homes
• Health system busy but coping
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H1N1 Planning
Current Status – What we Know
• Ontario Health Plan for an Influenza Pandemic is based on a set of assumptions that
anticipated a pandemic with a moderate to severe impact:
- Attack rate of 35% (approx 4.5M over the course of the pandemic)
- 12,635 fatalities
- 54,572 hospitalizations
• So far, pH1N1 has shown a mild impact (understanding that this MAY WELL increase in
the Fall and Winter):
- 4,221 confirmed cases: a general indicator, given lab tests are not routinely required
- 27 fatalities
- 431 total hospitalizations (with approximately 26 currently in hospital)
• Although the assumptions of the OHPIP have not been met, we are adapting our strategies
rather than doing away with them altogether
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H1N1 Planning
Central Role of Public Health
• Largest immunization effort ever in Canada, requiring mobilization of entire public
health sector
• Impacts on numerous other sectors; looking to public health for leadership
- Elementary and secondary schools
- Colleges and universities
- Faith groups
- Shelters and community service providers
- Front-line healthcare providers: such as hospitals, long-term care, family
physicians
• Communication is key: balanced approach – this is a different flu season
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