FHT Funding Agreements – concerns about “Requirement that all funded positions be employees”

The cover letter for all of the funding agreements MOHLTC has sent to FHTs contains a paragraph called “Requirement that all funded positions be employees”.  This post: ·         Summarizes specific issues AFHTO has collected to date, from e-mails and phone calls with EDs & lead physicians over March 24-25, 2011. ·         Reports on outcome of an initial conversation with Phil Graham, Manager of the FHT Unit (i.e. this requirement results from a government-wide directive) ·         Asks you to complete a brief survey so AFHTO can identify the depth and breadth of these issues, found at http://www.surveymonkey.com/s/MCCLLMZ . ·         Asks for potential volunteers who can be called on to form an AFHTO working group to find workable solutions on behalf of all FHTs, if needed. Requirement, as stated in the letter: 3 Requirement that all funded positions be employees To ensure consistency and alignment with enhanced accountability requirements, the following clause has been incorporated into the new Funding Agreement: “The Recipient acknowledges and agrees that all positions funded pursuant to this Agreement shall be employees of the Recipient unless the Ministry has provided its written consent for the use of an independent contractor. In no case, shall any portion of the Funds be transferred by the Recipient to any other person, corporation or entity for the purpose of paying for a position Funded pursuant to this Agreement, unless otherwise agreed to in writing by the Ministry.” Why has this requirement been introduced? This is to meet an Ontario government-wide directive implemented last September that applies to all government-funded transfer payment agencies. I requested a copy to get clarity on the scope and intent of this directive, and the criteria for the Ministry to determine exceptions. Apparently the document cannot be shared, but further background may be forthcoming in another week. Key problem areas identified by FHT leaders: ·         Barriers to recruiting community pharmacists, psychologists, dieticians who generally working in private practice and are contracted to work x hours per week in the FHT. Prescribed pay rates are below what they earn in their other roles. They appear to meet Canada Revenue Agency’s test for “independent contractor”. Conversion to an employment contract means payroll taxes will reduce their income further. ·         Contracts with outside agencies to provide services, e.g. mental health: in a number of communities, this was found to be the most cost-effective way to provide quality services to FHT patients. ·         Contracts for physician staff to fill part-time roles: where some roles are less than .5 FTE, some FHTs have found it more efficient to combine the role with one in the physician organization to create a full FTE position. Other issues raised by FHTs regarding the Funding Agreements: ·         The specific content of the schedules. These are unique to each FHT – each FHT will need to make sure they are accurate and negotiate the content with your MOHLTC consultant individually.  Keep in mind that this is your FHT’s “base” funding and activity for the next 5 years. Each year your FHT can apply for additions to your base or for one-time funding required to meet specific objectives in your annual operating plan. ·         Amount of time needed for full review with board and legal counsel. MOHLTC’s letter says “This Agreement must be signed and returned to the ministry by March 31, 2011 in order for the ministry to process the April 2011 payment.” Some FHTs received their Funding Agreements yesterday. ·         Time needed to implement changes to comply with the agreement. MOHLTC consultants have said FHTs would be allowed 6 – 8 months to transition to the new requirements (e.g. ensuring equal access to IHPs, implementing public complaints process, ensuring the FHT comprises all physicians contracted under a Physician Services Agreement). Next steps: Please click here to complete the brief survey – http://www.surveymonkey.com/s/MCCLLMZ . AFHTO’s Executive Director will continue to work on getting clarity regarding the scope and criteria for granting exceptions to the employee requirement. Your response to the survey will help in this matter. AFHTO will continue to keep you informed, and we appreciate your help in keeping the AFHTO board and me informed of developments as well.