Community for Life Investing In Peel Living. Thriving
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1 Health Services Presented to Council on December 1,
2 2017 Operating Investments Health Services Community for Life Investing In Peel Living People s lives are improved in their time of need $277.3 Million Thriving Communities are integrated, safe and complete Leading Government is futureoriented and accountable $0.1 Million 2 2
3 How We Serve the Community 3 3
4 How We Serve the Community 4 4
5 How We Serve the Community 5 5
6 How We Serve the Community 6 6
7 Doing Better 2016 Outcomes Meeting 5 of 6 response time framework targets Construction complete at 3 rd paramedic reporting station Redevelopment of Peel Manor site Implemented family caregiver supports 7 7
8 Doing Better 2016 Outcomes Completed 4 of 26 recommendations from the Aging Population Steering Committee 10% increase in consultations at breastfeeding clinics Enhanced smoking protection through water pipe by-law Advanced healthy food environments 8 8
9 Doing Better 89,500 volunteer hours Rapid response units used to lower response time Online prenatal classes improved access for parents by 70% Co-locating 15 of 24 paramedic stations has reduced capital expenditures by $5.2M Offload delay reduced by 12,800 hours due to process work at area hospitals 9 9
10 What s Changing Health system and provincial program changes: Patients First Act Ontario Public Health Standards Immunization 2020 Enhancing Emergency Services in Ontario Increasing complexity of care requirements in Seniors Services Staff health and safety needs Growth in call volume demand in Paramedic Services 10 10
11 Growing Community Need Projected Paramedic Call Volume by Age Segment 200, , , , , ,000 80,000 60,000 40,000 20, calls per 1,000 under 60 years 85 calls per 1,000 over 60 years 11 11
12 2017 Priorities Addressing changes in immunization requirements Increased surveillance of emerging issues (e.g. opioids) Healthy and age-friendly built environments Peel Manor site redevelopment and seniors hubs Evolving care model to address increased dementia Paramedic response times set by Council Physical/mental health and safety of staff 12 12
13 Operating Budget Total Expenditures by Program Paramedic Services $96.1M 34.6% Public Health $89.0M 32.1% Seniors Services $92.3M 33.3% Total Expenditures: $277.4 Million 13 13
14 Operating Budget Total Expenditures by Type Labour Costs $225.3 M 81.2% Other $10.2 M 3.7% Professional Services, $10.2 M 3.7% Operational Costs, $16.3 M 5.9% Contribution to Reserves, $15.3 M 5.5% Total Expenditures: $277.4 Million 14 14
15 Operating Budget Funding Source Provincial Subsidy $146.5M 52.8% Regional Tax $112.2M 40.4% Reserves $1.3M 0.5% User Fees $17.4M 6.3% Total Funding: $277.4 Million 15 15
16 Operating Budget Net Operating Budget by Program Program (In Millions) 2016 Net Revised Budget 2017 Net Budget Variance $ % Seniors Services % Paramedic Services (0.5) (0.9%) Public Health (0.8) (2.9%) Proposed 2017 Health Services Net Budget $111.6 $112.2 $ % 16 16
17 Operating Budget 2017 Budget Drivers 2016 Net Base Budget (In Millions) $111.6 Base Drivers: Annualization of 2016 budget decisions Inflation driven costs: Labour Costs/Goods & services Base provincial subsidy increase/reduced reserve contribution Budget expenditures reduced/offset revenue Increase (6.0) (0.4) Sub-total: Base Drivers ($1.2) 2017 Service Needs: Living Leading Sub-total: Service Needs $1.8 Proposed Total 2017 Net Budget $ Proposed Net Budget Change from 2016 $
18 Operating Budget 2017 Service Needs People s lives are improved in their time of need 2017 Gross Cost (millions) 2017 Net Cost (millions) I have access to services that meet my needs at all stages of life Paramedic Services To ensure timely access to Paramedic Services as per response time framework (5,500 additional calls): Add two 24/7 ambulances (19 FTEs; 50% funding). See Council report: October 13 th, 2016 Medical supplies and equipment increase due to call volume increase Paramedic Services total: Seniors Services To meet changing LTC resident and caregiver needs, especially related to dementia (11 FTE s; $991K); net of Case Mix Index funding ($350K) in See Council report: September 22, 2016 $2.7 $0.3 $3.0 $0.6 $1.3 $0.2 $1.5 $
19 Operating Budget 2017 Service Needs People s lives are improved in their time of need 2017 Gross Cost (millions) 2017 Net Cost (millions) I have access to services that meet my needs at all stages of life Public Health To prevent diseases and address changes to Provincial programming for Immunization Initiatives (8 FTE): managing immunization records in licenced child care settings, Human Papillomavirus Vaccine (HPV) for boys, screening for Immunization of School Pupils Act, Vaccine management and cold chain inspections. See Council report: October 13, 2016 To enhance surveillance and population health assessment to address emerging issues and enable better program decisions. Epidemiologist (1.0 FTE) Oral health program: transferred from cost shared to Healthy Smiles Ontario 100% funded program and additional 100% funding $0.8 $0.1 $0.1 $0.0 $0.0 ($0.5) TOTAL SERVICE NEEDS FOR LIVING (all Health) $4.7M $1.7M 19 19
20 Operating Budget 2017 Service Needs Government is future-oriented and accountable 2017 Gross Costs (millions) 2017 Net Costs (millions) I trust that the Region of Peel is a model and progressive employer Paramedic Services Investments in staff health and safety initiatives to improve the wellness of the workforce and return lost time (one-time draw from reserve) To ensure timely implementation of projects related to the health & safety, technology, research and system growth: Project Manager ( 1 FTE; 50% funding) $0.5 $0.2 $0.0 $0.1 TOTAL SERVICE NEEDS FOR LEADING $0.7M $0.1M 20 20
21 Operating Budget Summary of Net Operating Budget 2016 Net Base Budget (In $Millions) $ Base Drivers (1.2) Sub-Total: 2017 Cost to Deliver 2016 Service Level $ Service Needs - Living and Leading Total Proposed Net Budget $ Proposed Net Budget Change from 2016 $
22 2017 Capital Budget 2017 Capital Budget 22 22
23 2017 Capital Investments Health Services Living People s lives are improved in their time of need $17.3 Million Leading Government is future-oriented and accountable Thriving Communities are integrated, safe and complete 23 23
24 2017 Capital Budget Capital Requests People s lives are improved in their time of need Amount (in millions) I have access to services that meet my needs at all stages of life Seniors Services $6.8 Million Major facility repairs and equipment replacement to maintain state of good repair at the five long term care buildings Continued work on Health and Wellness Village at the Peel Manor site $4.1 $2.7 Paramedic Services - $10.0 Million Purchase of new and replacement vehicles and equipment Construction costs for new Paramedic facilities and maintenance of existing facilities Public Health - $0.5 Million Replacement of mobile dental clinic vehicle $3.5 $6.5 $0.5 TOTAL CAPITAL REQUESTS FOR LIVING $17.3M 24 24
25 Capital Plan Capital Plan by Program Seniors Services $142.5M 52.4% Paramedic Services $113.4M 43.2% Total 10-Year Capital Plan: $262.3 Million Public Health $6.4M 2.4% State of Good Repair $133.4M 51% Non-DC Funded Growth and Other Priorities $104.7M 40% DC Funded Growth $24.2M 9% 25 25
26 Budget Summary The Proposed 2017 Health Budget Includes: Operating Budget Total expenditures of $277.4 million; Net $112.2 million Address changes to Provincial Immunization programs and enhance surveillance Meet response times and implement key projects in Paramedics Increase capacity to address dementia care needs in Long Term Care Additional provincial funding enables base pressures to be offset for 2017 Capital Budget and Plan 2017 Budget: $17.3 million 10-Year Capital Plan ( ): $262.3 million Advancing work on the Peel Manor site redevelopment into hub, Paramedic facilities and maintenance of all assets 26 26
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