5/29/12

Hospital funding agreements delayed - but target June 30

Ontario hospitals are funded by the Local Health Integration Networks (LHINs) through "accountability agreements".

Last December 16, a joint steering committee of the LHINs and the Ontario Hospital Association met to discuss the process for 2012 and agreed "that the economic environment continues to remain challenging and that multi-year funding targets will likely not be provided." Accordingly, they aimed for a one year extension of the existing agreements (which started way back in 2008). Hospital Annual Planning Submissions  ("HAPS" -- the secretive documents that hospitals submit to the LHINs before the accountability agreements are finalized) were to be distributed to the hospitals in January, as were hospital funding  targets.  The plan was to have the accountability agreements in place when the existing agreements expired on March 31, 2012.

This was not to be.

Since then, the government announced new funding models for the hospitals.  This will alter the base budget for many hospitals and likely created some delay.

The forms for the HAPS only went out in April and the hospitals have received a preliminary estimate of their individual funding levels for the coming year. With the delay, hospitals have signed simple three month extensions of the existing accountability agreements, taking those hospitals through to June 30, 2012.

The goal, as of  April 17, was to sign-off the full 2012-13 accountability agreements "by June 30th in most cases" (although "agreement to negotiate extensions for a couple of weeks will not be unreasonably withheld"). They are giving some leeway to hospitals that find out their actual funding for this year is off by more than half a percent from their preliminary estimated funding. (It is not clear to me how reliable the preliminary funding estimates received by the hospitals are.)

The target date for the Hospital Annual Planning Submission to go to the LHIN is today -- May 29. Has this happened? That too is not clear to me. After the HAPS are submitted, the LHINs are supposed to review them and negotiate accountability agreements with the hospitals in their area.

As with the hospital Quality Improvement Plans discussed in the last post, your hospital accountability agreement is worth reviewing.  The agreements set out key government-set priorities for your hospital and conditions that your hospital must meet. As the government is the main funder of the hospital, those priorities are worth knowing: a hospital has to meet the terms of its agreement to get the funding.

As the new funding systems will change the base funding for many hospitals, the accountability agreements may be especially interesting this year. Compare it with last year's -- there may be some significant differences, as some hospitals get more (or less) than others.

Hospital accountability agreements should be posted on the web site of your LHIN and your hospital, when finalized.

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