In a special teleconference meeting Monday, Prairie North Regional Health Authority board members, some on holidays, approved a balanced budget for 2016-17 with "next to no new money," as described by CEO David Fan.
The region is already three months into the 2016-17 fiscal year, but the budget approval process was delayed due to the late tabling of the provincial budget this year.
For 2016-17, Prairie North Health Region's operating budget will be $286.3 million, an increase of $8 million over the previous year's operating budget. The additional dollars represent an increase in base funding from the Saskatchewan Ministry of Health and are targeted solely to collective agreement obligations, physician fee increases and inflation.
“This means our 2016-17 operating budget is basically status quo from the previous year,” said Bonnie O'Grady, PNRHA board chairperson. “Our fiscal environment remains challenging. We continue our focus on improving efficiencies to ensure long-term sustainability, while maintaining our emphasis on continuous safety and quality improvement to ensure appropriate access to and delivery of patient- and family-centred care,” she stated.
The region counts on two large sources of funding, said Fan. One is the base funding from the Ministry of Health and the other is the funding that comes from Alberta for the delivery of health service in Lloydminster,
Fan said this year's funding from the Ministry of Health is $220 million, $8 million more than last year. Most of that increase is related to collective agreement obligations and medical remuneration.
Funding due from Alberta has been estimated at $36.7 million, given last year's figure of $36.4 million.
"It's fair to say at this point we have no indication for ‘16-17 from Alberta yet," said Fan. "It is still something under discussion, but we need to plug in a number and so we are using a best guess to build our budget for ‘16-17."
The rest of the revenue comes from a variety of sources, including long-term care resident fees, home care fees and other fees, as well as donations.
While the region is looking at projected revenue of $287 million, it is also projecting operating expenses amounting to $286 million. A projected operating surplus is $820,000. Most of that is earmarked for repayment of an earlier debt.
"We have to run a surplus in order to pay our mortgage of $812,000," said Fan. "Those mortgages are a long-standing obligation. Long-term care homes that were built in the past were financed quite differently, by taking out mortgages, so each year we have to set aside dollars."
He said, "By the time we pay our mortgage of about $812,000, our projected surplus is really minuscule," – $7,082.
On the expense side, Fan said the largest expense is compensation for health care providers.
Health region employees will receive approximately $170 million. At least $23 million goes out to individuals who are part of a payment scheme rather than fee for service. There are also a number of grants to organizations such as Canadian Mental Health Association and to private ambulance services – WPD Ambulance in the Battlefords and Lloydminster and Marshall Ambulance in St. Walburg. Other expenses fall under a variety of categories from utilities and infrastructure repairs to surgical supplies and drugs.
The budgeting process was further impacted by a provincial directive for Saskatchewan's health regions to collectively find administrative savings to the tune of $7.5 million, said Fan. The savings are to be directed toward more positions for front line staff in the region's long-term care facilities.
"Our share of that is $448,000 and that is determined based on the number of long-term care beds in the health region in the context of the whole province," he said. "So we have to find 70 per cent in administrative positions and 30 per cent of that in other administrative costs."
Of the $448,000, about $315,000 is tied to positions, and about $133,000 tied to other administrative overhead costs, said Fan.
To meet the directive, there are six positions being targeted, of which four are out of scope and two are in scope. They total 3.4 FTEs. There are four positions that have been vacant that now won't be filled.
"The responsibilities and duties will be reassigned and dispersed differently, so when the dust settles there are two positions with people in them that will be affected," said Fan. "One is in scope, one is out of scope. At this point we need to follow a process, we have to have conversation with our unions to find some ways to manage that in scope – out of scope is dealt with quite differently."
For the 30 per cent associated with other administrative overhead costs, last year, the region budgeted $520,000, and spent about $500,000, he said.
"This year we are budgeting a lot less," said Fan.
Many of those recruitment dollars are related to recruiting physicians.
"What effect it will have in terms of ability to recruit, I guess time will tell," he said.
With the overall administrative savings, the region will be able to invest $448,000 in front-line long-term care staffing. There are 13 long-term care facilities in the region, however two are on the Alberta side, said Fan. Because the program affects Saskatchewan only, 11 out of 13 will be considered for more staff. Out of the 11, eight will see new front-line positions added totalling 5.8 FTEs. Of those, 2.3 are for licensed practical nurses and 3.5 are for continuing care aides.
Facilities earmarked for new positions are Battlefords District Care Centre in Battleford, River Heights Lodge and Villa Pascal in North Battleford, Maidstone Health Complex, Riverside Health Complex in Turtleford, Northlands Pioneer Lodge in Meadow Lake, L. Gervais Memorial Health Centre in Goodsoil and Jubilee Home in Lloydminster.
"Depending on how quickly we can actually reduce the costs, what we are contemplating is that those new positions will likely start to be added to the complement some time in the fall, at the latest December of 2016."
He added, "Further to this investment of $448,000 in long-term care, it's fair for me to point out at this point that investment in senior care has been a priority for Prairie North for the last several years."
“In 2013-14, the board directed that $500,000 be targeted to long-term care enhancements,” said O'Grady. “In 2014-15, the provincial Urgent Issues Action Fund provided over $500,000 for further improvements to long-term care staffing and facilities. Funding came from the governments of Saskatchewan and Alberta to launch the Home First/Quick Response program in Lloydminster in 2014-15. In 2015-16, the new Alberta-funded Lloydminster Continuing Care Centre opened and Lloydminster Home Care completed its first full year of operation of the Home First program. New funding was provided by Saskatchewan to launch Home First in The Battlefords. The Region also continued its upgrade of nurse call/patient safety systems in several facilities.”
In 2016-17, home care services for Battlefords and area residents will see its first full year of operation of the Home First/Quick Response program.
