New jobs prohibited by one-time funding

Some good news and some bad news.

The good news is many health care providers in the Central East LHIN (and likely others) will receive substantial increases in funding, some for the first time since 2011/12.

The bad news is that this will only last for a little over two months more. Then the funding levels go back to where they were before.

Here’s the kicker – all this additional service has to be done without hiring any new staff. That’s because new hires represent a commitment beyond March 31st. That’s a no-no in one-time funding.

The government does this every year resulting in a sudden influx of cash to select targeted programs, and then suddenly it all dries up again.

The Ministry routinely comes up with pockets of one-time cash given to the LHINs on short notice. For example, December 16th the Ministry made available $8 million in one-time funding to support the Health Action Plan’s “Assess and Restore” policy. That policy aims to focus on preventative programs for seniors. The LHINs each had until December 20 to figure out how to spend that money – just four days.

Fortunately the LHINs are becoming more used to this ludicrous way of allocating health care funding. In the Central East’s case, they were prepared. Rouge Valley, Campbellford Memorial Hospital and the Peterborough Regional Health Centre, will be able to carve out more physiotherapy hours for their existing part-timers from January to March. It amounts to anywhere from $18,000 to $32,000 for each hospital. The Scarborough Hospital will be able to improve care transitions with a one-time influx of $190,000. Ross Memorial is using almost $15,000 to extend rehabilitation assistant coverage. Other hospitals are using the funds towards education programs and enhanced care coordination. And like Cinderella’s carriage, these initiatives will all turn back into pumpkins come April 1st.

While there is a normal surge in demand during these months, assess and restore is hardly a seasonally dependent activity.

In a province where the jobless rate is stubbornly high, the one-time funding also works against any permanent employment.

One-time funding also frequently becomes available as a result of the Ministry dragging its heels on other base funding increases. You may recall that last year the influx of new money for home care was announced very late in the year, making it impossible for Community Care Access Centres to apply it entirely to the base funding it was intended to cover. Instead what cannot be spent by March 31st often gets reallocated into other one-time projects with the same rules – no new jobs.

This year the delay is in the transfer of community investments meant for Community Health Centres (CHCs) and other agencies. The Central East LHIN, for example, has determined that $7.5 million of the $27.8 million allocation cannot be spent as planned and is reallocating it as more one-time funding. That means CHCs and Community Support Services will get between 6 per cent and 10 per cent across-the-board increases provided they can spend the money before March 31st. CHCs and agencies that are running current surpluses will not be eligible — in Ontario prudence never pays. In this case the money is being earmarked towards community projects that will help hospitals reduce their alternate level of care rates and readmissions. Some of the money will also be used to support Health Links partners.

Any health provider running a surplus is obliged to give it back unless they can show there are existing financial obligations that slip into the next fiscal year.

Not all services get helped out with this winter largesse. It looked like 600 cataract surgeries were to be cancelled at Hamilton St. Joe’s earlier this week. The hospital had run out of earmarked funds for the surgeries. However, in the spirit of the season (and two by-elections), the Minister of Health did extend some additional cataract cash to the LHIN, likely saving two-thirds of the scheduled surgeries at St. Joe’s.

It’s a funny way to fund a health system.

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