Report No. 033-12
TO: Chair and Members of the Board of Health
FROM: Graham L. Pollett, MD, FRCPC, Medical Officer of Health
DATE: 2012 February 16
2012 Budget Approval Process - Update
Recommendation
It is recommended that Report No. 033-12 re 2012 Budget Approval Process – Update be received for information.
Background
The purpose of this Report is to bring the Board of Health up to date concerning the City of London approval process for the 2012 Revised Board of Health approved budget.
Since the January 19th Board of Health, meeting there have been two (2) meetings of the Strategic Priorities & Policy Committee (SPPC). This Committee is comprised of all members of Council and is chaired by Mayor Fontana. It is responsible for reviewing the operating and capital budgets. Following the January 19th Board of Health meeting where the Board approved a revised 2012 City of London budget submission calling for a 1.6% ($100,000) reduction to the previously approved submission, a revised notice to this effect was provided to City Council. This notice is required under Section 72(5) of the Health Protection & Promotion Act (HPPA). The revised notice is attached as Appendix A.
On February 2, 2012, the revised budget submission was considered by the SPPC. At this meeting, the Medical Officer of Health; Mr. John Millson, Director, Finance and Operations; and the Board Immediate Past Chair and City Appointee, Ms. Patricia Coderre responded to Committee members’ questions for approximately one hour. The outcome of this meeting is summarized through the following Committee resolutions.
(a) The MLHU BE REQUIRED to reduce the City-funded portion of the budget by $496,000, in accordance with the previous direction of Council in order to continue to work toward the City funding only 25% of the MLHU; and,
(b) The MLHU and the City Solicitor BE REQUESTED to report back to the February 9th meeting of the SPPC with respect to the impacts to mandatory programs and any potential legal implications based on existing agreements including the Public Health Accountability Agreement with the Province.
As per Board of Health direction at the January 19th Board meeting and consistent with the request of the SPPC regarding legal implications, a legal opinion was sought from the Health Unit Solicitor. This opinion confirmed the City Council obligation under Section 72(1) of the HPPA to approve the revised 2012 Board of Health budget submission (see Appendix D).
In addition, staff undertook a survey of the current cost-sharing funding arrangements in place for each of the province’s 36 health units. At the January 19th Board meeting, it was reported that at least 13 health units were receiving greater than 25% from their municipal funder(s). This was as a result of a survey conducted in 2011 by the Kingston Frontenac Lennox & Addington Health Unit. However, the names of the 13 health units with altered cost-sharing arrangements had not been disclosed. In response to a Board member’s request for actual names, it was necessary for staff to undertake a separate survey.
The results of this Health Unit’s survey are attached as Appendix B. It will be noted that the actual number of health units with an altered cost-sharing formula is 19 (53%). Of these 19, 7 receive 32% or more of their funding from municipal sources. This information was forwarded to all members of the Board and all members of City Council.
The Board Chair and the Medical Officer of Health were unsuccessful in scheduling a meeting with Mayor Fontana to discuss the 2012 Board of Health revised budget. A request to make a presentation at the February 9, 2012, SPPC meeting was not approved. The PowerPoint presentation that was to have been made was forwarded to all members of Council and the Board of Health (Appendix C). On February 8th, the Board of Health legal opinion was forwarded to the Mayor and City Council as well as a letter reaffirming the revised budget submission of $6,095,059 Appendix D).
City of London Budget Meeting – February 9, 2012
On February 9, 2012, the SPPC reconvened to review the status of the City’s operating and capital budgets. This meeting was attended by the Board Chair, Ms. Viola Poletes Montgomery, the Medical Officer of Health, Associate Medical Officer of Health, Dr. Bryna Warshawsky, Mr. Millson, and Director Human Resources and Labour Relations, Ms. Louise Tyler. Mr. David Woodward, Health Unit Solicitor, was also present for the meeting.
The Committee passed the following resolutions for consideration by City Council at its upcoming final budget meeting February 21, 2012 (each resolution was voted on separately with a recorded vote):
1. That the following actions be taken with respect to the 2012 Budget request of the Middlesex- London Health Unit:
a) the Civic Administration BE DIRECTED to submit to the Middlesex-London Health Unit (MLHU) Board, payments in accordance with the Health Protection and Promotion Act (HPPA) in the amounts required by the MLHU Board’s notice under section 72 of the HPPA, at the times required by the notice; and
b) the 2012 Budget BE REVISED to reflect the payments noted in a) above.
14 in favour, 1 not in favour
2. That the City Treasurer, Chief Financial Officer BE INSTRUCTED to consult with the Middlesex- London Health Unit (MLHU) Board with a view to developing a by-law to provide for the form and detail of future estimates and the dates they are to be submitted annually, pursuant to section 290(6) of the Municipal Act, 2001 which addresses the achievement of the 75/25 provincial/municipal cost sharing formula.
15 in favour, 0 not in favour
3. That the Minister of Health and Long-Term Care be requested by the Municipal Council of the City of London to cause assessors appointed under section 82 the HPPA to carry out an assessment of the MLHU Board under section 82(3) of the HPPA (See Appendix E for full wording of Resolution 3).
9 in favour, 6 not in favour
Detailed Budget Information Request
During this budget review process, several Board members requested detailed budget information. The usual practice for a request of this type is to provide the information to all Board members by means of a Board Report. However, given the challenging nature of the 2012 budget process, the line by line 2011 Provincial budget document, together with a covering memo highlighting the changes for 2012, were forwarded electronically to all Board members in advance of the Board of Health meeting (Appendix F). Staff will review this document at the February 16th Board of Health meeting.
At the January 19th Board of Health meeting, Board members by resolution decided not to establish standing committees for 2012. In light of the SPPC Resolutions and heightened interest in the Board of Health’s finances, the Board may wish to reconsider this decision through the establishment of a Finance Standing Committee.
Summary
At the October 20, 2011 meeting, the Board of Health approved a 2012 budget. This budget called for a 0% budget increase from each of its municipal funders i.e., the City of London and County of Middlesex. This was consistent with the 2005 Board of Health Business Plan which called for a strengthening of local public health capacity as directed by the Ministry of Health and Long-Term Care through provincial budget increases with no additional cost to either the City or the County. The Business Plan had been approved each year up to including 2011 and has resulted in no increase in funding to the Health Unit from either the City of London or County ofMiddlesex since 2004.
In response to City Council’s expressed objective of minimizing the 2012 property tax increase and in recognition of local economic conditions, the Board of Health at the January 19, 2012, meeting, revised the 2012 budget submission. That is, the 2012 budget was reduced by 1.6% ($100,000).
At the February 9, 2012, meeting of City Council’s Strategic Priorities and Policy Committee, a resolution was passed for consideration at the February 21st City Council meeting calling for approval of the revised 2012 Board of Health budget submission. In addition, the Committee passed resolutions directing City and Health Unit staff to work toward an expedited schedule for achieving a 75% provincial 25% municipal cost-sharing arrangement as well as a resolution to formally request the Minister of Health and Long-Term Care to appoint an assessor to undertake an assessment of the Middlesex-London Board of Health.
Mr. David Woodward, Health Unit Solicitor, will be in attendance at the February 16th Board of Health meeting to address the Strategic Priorities and Policy Committee resolutions.
Graham L. Pollett, MD, FRCPC
Medical Officer of Health
Last modified on: February 14, 2013