House Calls, #956, January 26, 2025: Squaring the Circle

Glen Gower, an excellent city councillor introduced a motion at Ottawa City Council ion December 2024 to bring a Primary Care Hub to Kanata-Stittsville.

I discuss whilst this motion is admirable and has its heart in the right place, why it is unlikely to result in its professed goals. THere are more straightforward means of accomplishing these goals without the end result of budget overruns and increased levels of bureaucratic oversight.

Indeed, the formation of a specific health team called the FHT or Family Health Team requires funding for a cavalcade of reporting instead of it being directed to seeing patients in the office.

This form of bean-counting does not improve access to care. It drains much needed funds from front line care and support.

Apologies for the eye glazing list of metrics that are required for monitoring and operating an FHT. The list is at the end of this post.

Your Calls and Comments:

  • Accidentally taking a double dose of Amoxil for a day while being treated for pneumonia. What happens when the medication runs out early?
  • Do nails grow more quickly as we age?
  • Muscle aches and darker urine in a person taking colchicine. What should they do?

Here are more detailed explanations for each of the Family Health Team (FHT) reporting obligations to the Ontario Ministry of Health and Long-Term Care (MOH):

Annual Service Plan and Budget (ASP&B):

Purpose: This document provides an operational plan and financial projections for the forthcoming fiscal year.

Content: It encompasses service delivery plans, projected patient volumes, health promotion activities, and detailed budget allocations for personnel, equipment, and programs.

Frequency: Submitted annually.

Compliance with Accountability Agreement:

Purpose: To ensure that Family Health Teams (FHTs) adhere to the terms established by the Ministry of Health (MOH) regarding service delivery, financial management, and operational standards.

Content: The agreement outlines performance targets, financial controls, and the methods by which the FHT will fulfill its commitments to patients and the community.

Monitoring: Regular audits or reviews may be conducted to verify compliance.

Costing Information by Program:

Purpose: To provide transparency and accountability for fund allocation across various services or programs.

Content: Detailed breakdowns of costs associated with each program, including personnel, supplies, and administrative expenses.

Use: Assists in evaluating program efficiency and effectiveness.

Financial Oversight and Records Management:

Purpose: To maintain fiscal responsibility and ensure the appropriate use of public funds.

Content: Includes maintaining comprehensive records of all financial transactions, having these records audited, and preparing annual financial statements.

Requirement: Records must be kept in a manner that facilitates easy review by the MOH or external auditors.

Procurement Practices:

Purpose: To ensure procurement processes are fair, transparent, and cost-effective.

Content: FHTs must follow procurement guidelines similar to those under the Municipal Act, which may involve competitive bidding for larger purchases.

Compliance: Reporting may be required if there are specific procurement thresholds or processes needing ministry oversight.

Unused Grant Reporting:

Purpose: To account for all funding provided by the MOH.

Content: Reporting on any unspent portions of grants, providing reasons for the surplus, and potentially returning unused funds or reallocating them as directed.

Frequency: Requests for reporting may occur at the end of fiscal periods or in response to specific inquiries.

Repayment of Funding:

Purpose: To ensure the appropriate use of public funds and to recover any misallocated or unspent amounts.

Content: If funds are not utilized as per the agreement, or if there is an overpayment, Family Health Teams (FHTs) may be required to repay these amounts.

Action: This typically involves a formal process wherein the Ministry of Health (MOH) requests repayment, often following an audit.

Accurate Expenditure Forecasts:

Purpose: To aid in financial planning and resource allocation by the ministry.

Content: Forecasting future expenditures based on current trends, planned initiatives, and anticipated patient load.

Importance: Assists in budget negotiations and securing funding for the subsequent fiscal year.

Compliance with Legislation:

Purpose: To ensure FHTs operate within the legal framework of healthcare delivery in Ontario.

Content: Compliance with the Health Protection and Promotion Act, along with other relevant legislation such as privacy laws (PHIPA), employment standards, etc.

Monitoring: This may involve regular self-audits or external audits to confirm adherence.

Performance and Quality Metrics:

Purpose: Although not strictly a reporting obligation, FHTs are expected to demonstrate their performance through various metrics.

Content: Could include patient satisfaction surveys, health outcomes, access to care metrics, etc.

Evaluation: These metrics might be part of broader evaluations or studies by bodies like the Conference Board of Canada, influencing future funding decisions or policy adjustments.

These obligations ensure that FHTs operate transparently and effectively, aligning with the overarching goals of the Ontario health system. It is important to note that these details may evolve with changes in policy or new requirements from the MOH.