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 :

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

 

City Wide / À l’échelle de la ville

ACS2011-OPH-IQS-0009

 

 

SUBJECT:

PUBLIC HEALTH ACCOUNTABILITY AGREEMENT

 

 

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.

 

CONSULTATION

The MOHLTC surveyed health units including board members in May 2011 regarding the proposed Accountability Agreement.

 

LEGAL IMPLICATIONS

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.

 

SUPPORTING DOCUMENTATION

Document 1- Public Health Accountability Agreement 2011 (kept on file with the Board Secretary)

 
DISPOSITION

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.