May 9, 2013 - Minutes

Members Present:

Mr. David Bolton
Ms. Denise Brown (Vice Chair)
Mr. Al Edmondson
Ms. Trish Fulton
Mr. Marcel Meyer (Chair)
Mr. Ian Peer
Ms. Viola Poletes Montgomery
Ms. Nancy Poole
Ms. Sandy White

Regrets:

Mr. Stephen Orser
Mr. Mark Studenny

Others Present:

Mr. Wally Adams, Director, Environmental Health and Chronic Disease Prevention Services
Ms. Marylou Albanese, Manager, Healthy Communities and Injury Prevention Team
Ms. Diane Bewick, Director, Family Health Services
Mr. Maurice Chang, Director, Management Consulting, PricewaterhouseCoopers
Ms. Melody Couvillon, Manager, Procurement
Mr. Dan Flaherty, Manager, Communications
Mr. Ross Graham, Manager, Special Projects
Mr. Grant Hopcroft, Director of Intergovernmental & Community Liaison, City of London
Mr. Mark Hunt
Dr. Christopher Mackie, Medical Officer of Health and CEO
Mr. John Millson, Director, Finance and Operations
Mr. Mark Przyslupski, Acting Manager, Information Technology Services
Ms. Gayle Riedl, Manager, Human Resources
Ms. Sherri Sanders, Executive Assistant to the Board of Health (Recorder)
Mr. Chirag Shah, Partner, Audit and Assurance Group, PricewaterhouseCoopers
Ms. Pat Simone, Manager, Emergency Preparedness
Ms. Linda Stobo, Manager, Chronic Disease Prevention and Tobacco Control Team
Ms. Louise Tyler, Director, Human Resources and Labour Relations Services
Mr. Alex Tyml, Online Communications Coordinator
Dr. Bryna Warshawsky, Associate Medical Officer of Health and Director, Oral Health, Communicable Disease & Sexual Health Services

Media Outlets:

Mr. Chuck Dickson, CTV
Ms. Victoria Mattan, CTV

Board of Health Chair, Mr. Marcel Meyer, called the meeting to order at 7:15 p.m.

Chair Meyer reported that Ms. Brown would be arriving around 7:30 p.m. as she was coming from another meeting. Ms. Poletes Montgomery will be arriving around 8:30 p.m. as she is coming from a personal obligation.

Disclosures of Conflict(s) of Interest:

Chair Meyer inquired if there were any disclosures of conflict of interest to be declared. None were declared.

Approval of Agenda

It was moved by Mr. Peer, seconded by Mr. Bolton that the Agenda for the May 9, 2013 Board of Health meeting be approved. Carried

Reports

1) Report No. 061-13 re “Minister Approval – Medical Officer of Health”

It was moved by Mr. Edmondson, seconded by Ms. Fulton that Report No. 061-13 re “Minister Approval – Medical Officer of Health” be received for information. Carried

2) Report No. 062-13 re “Election of Secretary-Treasurer”

It was moved by Ms. White, seconded by Mr. Peer that Dr. Christopher Mackie be elected Secretary-Treasurer of the Board of Health. Carried

3) Report No. 063-13 re “PricewaterhouseCoopers Interim Report – May 9, 2013”

Chair Meyer welcomed Mr. Chirag Shah, Partner, Audit and Assurance Group, and Mr. Maurice Chang, Director, Management Consulting, PricewaterhouseCoopers (PWC), to assist Board members with their understanding of this report.

Mr. Chang walked Board members through the Interim Report Phases I and II page by page. PWC was hired to determine potential efficiencies and cost saving in the Health Unit’s administrative functioning, including the possibility of shared services with the City of London and Middlesex County. This report concludes Phase II of the project.

In response to a question about what percent of the Health Unit budget would $2.1 million over 3 years be to reach a 75%/25% cost sharing arrangement, Mr. Millson responded that it would be about a 10% reduction before inflation of the $23 million cost-shared budget.

In response to a question about why internal savings should be examined before shared services, Mr. Chang explained that the shared services model is part of phase III. He also explained that the Health Unit must have its internal processes as efficient as possible before be examining shared services as costs could actually increase because of layering on additional processes.

It was noted that this Health Unit is currently 23^rd out of 36 health units in per capita funding from the Province. A question was asked about what percentage increase in the budget would this health unit need to receive to be able to approach the middle of the pack? Mr. Chang explained that PWC did not have this calculation.

Mr. Chang highlighted the strengths in the baseline finding (page 9) of the report.

Ms. Brown arrived at 7:35 p.m.

It was noted by Board members that the Health Unit is spending on IT costs per employee is less than the generic bench mark. Mr. Chang reported that in Phase III of the project, PWC would compare this spending to the City and the County. PWC did not have access to comparison data from other Health Units.

Mr. Chang emphasized that the report does not suggest that operational expenditures are being driven by the budget, but that there are opportunities for improving the health unit budget process (page 18).

It was noted by a Board member that the factors influencing the Health Unit budget process are similar to those in any other publicly funding agency in the country. Mr. Shah agreed and explained that what is missing is a framework to look at in-year reallocation of resources, so that once assumptions change, staff can go back and reallocate the budget accordingly. This would be based on a strategic prioritized “shopping list” determined by Senior Management and the Board.

Mr. Millson explained that the City of London is already giving its budget targets for 2014 at a time when the Health Unit does not know the 2013 provincial grant. Mr. Shah explained that what is needed is a model to develop base costs for core programs and services with a prioritization process for how any remaining money is used.

Ms. Poletes Montgomery arrived at 8:25 p.m.

Mr. Chang and Mr. Shah recommended that the Board of Health should work towards making the Health Unit as efficient as possible internally before exploring other strategies, including shared services.

Concern was expressed by Board members about the age of data (2005) used on page 34 which compares sharing of administrative functions in Ontario public health units. Mr. Shah explained that this is the more recent data available, and collecting new data was not in the scope of the first two phases of the project. Dr. Mackie reported that staff would need to know more current information in order to make decisions and recommends that collecting new data across the province should be part of phase III. It was also recommended by a Board member to compare and assess outsourcing of services, because it does not always produce savings, if and when the Board decides to proceed in that direction.

In response to a question about what investment is needed to move to the next level of the model, Mr. Shah responded that the major investments would be staff time, training and technology. Board members questioned what the investment in technology would be. Mr. Shah responded that the quantification would be part of Phase III.

It was discussed that there would be great value to refining the metrics to measure input and output together (Key Performance Indicators or KPI’s).

It was moved by Ms. Brown, seconded by Ms. Poole that the Interim Report be received for information and that the Board’s direction to PricewaterhouseCoopers be deferred until the May 16^th Board of Health meeting to give Board members the opportunity to review notes and consider the information presented.

It was moved by Mr. Edmondson, seconded by Ms. Brown that the motion be tabled until Mr. Shah and Mr. Chang of PricewaterhouseCoopers finish the presentation of the Interim Report. Carried

Ms. Brown was asked what additional research she wanted to do in regard to the Interim Report. She replied that City Hall staff could find more current information about the 2005 Study of Ontario’s Health Units and get some of the information she would like.

The Board requested that any additional research conducted by Board members on the Interim Report be shared with all Board members at the May 16^th Board of Health meeting.

Dr. Mackie offered the assistance of Health Unit staff members if any Board member has questions about the Interim Report or requires more information.

Mr. Shah and Mr. Chang completed the presentation.

Concern was expressed by several Board of Health members about how Health Unit staff must be feeling throughout this process. It was emphasized that although the Health Unit must be fiscally responsible, it also must be considerate of staff morale. Concern was expressed that some of the report findings are “nickel and diming” and the Board does not want to get careless and forget about the employees and the quality of programs and services offered to the community.

Board members were reminded that only the Chair should make remarks to media according to the Board Member Code of Conduct.

At 8:55 p.m. the Motion was brought forward for further discussion.

In response to a question about PricewaterhouseCoopers’ vision of Phase III, Mr. Chang explained the key work in phase III would be “quantification”. This would include, for example, comparing FTE’s of the City and County and technology, so that the board can prioritize. The time frame was approximately 4-6 weeks.

Other Business

Next scheduled Board of Health Meeting 7:00 p.m. – Thursday, May 16, 2013

Adjournment

At 9:00 p.m., it was moved by Mr. Bolton, seconded by Mr. Peer that the meeting be adjourned. Carried

MARCEL MEYER
Chair

CHRISTOPHER MACKIE
Secretary-Treasurer