FHT Directors representing AFHTO and AOHC members met with the FHT Unit on Wednesday. To access the full report, please click here. The main focus of the meeting was the discussion on budget flexibility and accountability. The FHTs presented the position proposed by the Executive Director Advisory Council at their meeting of August 28, which was to achieve:
- A global budget divided into two envelopes, one for HR and the other for operations, such that:
- The HR envelope should allow for complete flexibility in determining the positions.
- A provincial salary grid for each position should continue to be enforced to avoid unproductive competition for staff (with movement toward a more competitive primary care compensation structure, as advocated in the Compensation Structure for Ontario’s Interprofessional Primary Care Organizations report from AFHTO, AOHC and NPAO.)
The EDAC position was approved by the AFHTO board and is supported by the AOHC C-FHT Executive Directors. (To access the briefing note on this position, please click here.) The MOHLTC FHT unit agrees that, given the current fiscal constraints and the stage of development of some of the FHTs, moving towards increased budget flexibility and reviewing the accountability framework is the right direction. All parties agreed that a staged approach that would be developed with a goal of moving a number of FHTs to a hybrid global budget for the next fiscal year, contingent on final ministry decisions. All have committed to collaborate on the first two steps to move this forward:
- Readiness assessment: Through EDAC, AFHTO will prepare initial draft of criteria for assessing FHTs in terms of their readiness to govern and manage a more flexible budget.
- More meaningful accountability reporting: MOHLTC will share their initial work to review the reporting structure as a starting point for further discussion on changing the accountability framework.
There remains the need to find ways to ensure decisions about the size of budgets can remain consistent with changing demands and conditions over time. The meeting also provided the opportunity to review with the Ministry the process to address current budget pressures. The Ministry re-affirmed its commitment to ensure that the budget reductions do not impact negatively on patient care. The Ministry coordinators have been instructed to be flexible and to work with FHTs on a case-by-case basis to free up funds within the approved FHT budget, or if necessary consider other measures. The Ministry provided updates on a number of issues identified by EDAC:
- Status of the BSM review
- Sessional fees
- Transfer of rostered patients
- Quality Improvement Plans
- QIDSS Program
- IHPS in non-FHT models
- Physiotherapy in FHTs
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