AFHTO’s Executive Director Advisory Council (EDAC) met on July 25 with the main purpose of preparing to respond to the Ministry’s interest in extending greater flexibility for budgets with corresponding improvements in the accountability reporting process. EDAC’s mandate is to advise the AFHTO board and staff on matters affecting the operations of our member organizations. Please scroll down further for updates on additional operational matters covered at this meeting. Improving budget flexibility and accountability With the number of funding pressures facing primary care organizations, there is growing interest within the Ministry to grant greater budget flexibility for FHTs and NPLCs (consistent with CHCs) to solve the problems they face, balanced with appropriate accountability for public funds. The challenge is differing expectations of the extent to which problems could be solved within existing funding envelopes. At AFHTO’s June 3rd meeting with the FHT Unit, held in conjunction with the Association of Ontario Health Centres (AOHC), the Ministry committed to convening a joint AFHTO-AOHC –MOHTLC working group in the fall to begin to understand and address the issues. This EDAC meeting therefore focused on identifying the desired “end state” for FHT budgets, particularly focusing on the implications and specific challenges for FHTs in possibly moving towards global budgets. A number of EDAC members will work over the month of August to review the issues in detail and provide a report at the next EDAC meeting, to be held on August 26. Report back on previous operational issues that had been raised:
- Audit standards: MOHLTC confirms FHTs are designated as “not under government control” Canadian accounting and auditing standards have gone through some changes. The Accounting Standards Board has decided to pursue separate reporting strategies for each major category of reporting entity: publicly accountable enterprises, private enterprises and not-for-profit organizations. The MOHLTC has determined that FHTs cannot be considered to be government not-for-profit organizations. Ministry legal counsel has reviewed the clauses and confirmed that FHTs are not under government control.
- Blended salary model review: Because this deals with physician compensation and working conditions, it is an issue for MOHLTC and OMA to address in negotiations process. AFHTO and AOHC continue to monitor to identify timing/issues for BSM FHTs to be directly involved.
Resources to be developed and shared with AFHTO members:
- Preparation for implementation of the Ontario Not for Profit Corporation Act (ONCA): ONCA is currently scheduled to take effect in January 2014. Introduction has been delayed a few times as the Act continues to undergo revisions. Once the Act is proclaimed all not-for-profit organizations will have three years in which to conform to the new Act. Once the Act’s requirements are finalized, AFHTO will work with legal experts and FHTs who have already started to prepare for the changes to develop resources and support to ensure that all FHTs can meet the requirements of the revised legislation when it is in effect.
- Infection control standards and policies: AFHTO will gather resources from FHTs who have developed specific infection control standards and policies and make these resources available to all FHTs by the mid-August.
- Approach to third party billing: There appears to be wide variations in how FHTs manage the funds that they are receiving from third party billing and in the responses from the MOHLTC coordinators when request to utilize these revenues are made. Given that physiotherapists will be joining some of our FHTs, the opportunity for revenue from third party billing may increase for FHTs.AFHTO will work with EDAC to develop a common approach to third party billing.