1. 1 RHD Cost Sharing Review Update 2010 UBCM Convention Presented by RHD Cost Review Working Group September 27, 2010

2. 2 RHD COST SHARING REVIEW UPDATE Background 2008 report reviewed status of implementation of recommendations of the 2003 RHD Cost Sharing Review Working group established in June 2009 and composed of UBCM, RHD, MoHS and HA representatives Presented update at 2009 Convention in Vancouver Updates and reports posted on UBCM Healthy Communities Committee webpage 2010-09-27

3. 3 Committee Work on Recommendations (Sept 2009 – Sept 2010) Recommendation 1: Capital Planning Horizon Recommendation 5: Educational Materials on P3s RHD COST SHARING REVIEW UPDATE 2010-09-27

4. Capital Planning Horizons Ministry is striving to develop a regular capital planning and funding cycle that works for:  Health authorities  Regional Hospital Districts  Ministry of Health Services Capital planning cycle is influenced by: Government’s capital planning cycle Availability of provincial capital funding Availability of RHD capital funding 42010-09-27

5. Capital Planning Horizons Since 2008: 3 year capital plan MoHS and HAs are aware of capital requirements for health infrastructure Economic downturn has impacted capital funding resources which in turn, impacts capital funding supply Availability of provincial capital funding impacts the timing of projects which impacts when RHDs will be asked for capital funding Impacts when RHDs can provide capital funding 52010-09-27

6. Capital Planning Horizons 2010 and onwards: MoHS is developing a medium-term capital plan 4 year plan and forecast funding for up to 6 years Intended to be a rolling plan (year-upon-year) New provincial funding unlikely to be confirmed until late 2010/early 2011 Provincial capital budget cycle continues to be a challenge coordinating with RHD budget cycle MoHS will inform HA’s of available capital funding for future years as soon as possible – and in turn, RHD’s can be advised. 62010-09-27

7. Public Private Partnerships 72010-09-27 See separate presentation

8. No.RecommendationStatus 1Develop long range capital plansOngoing 2Define fixed funding amounts (RHD,HA)Working Group reviewing draft 3Develop draft capital plans (HA)Moved to 2010/2011 workplan 4Update/confirm definition of capitalBeing assessed through Capital Assessment Management Framework review, Office of Comptroller General 5Develop P3 educational materialsNearing Completion 6Clarify principles & mechanisms to improve communication (MoHS, RHD, HA) Moved to 2010/2011 workplan 7Develop process to ensure regular meetings between HAs + RHDs Moved to 2010/2011 workplan 8Schedule semi-annual meetings btw RHD + HAsMoved to 2010/2011 workplan 9Define mechanisms for ad hoc updatesMoved to 2010/2011 workplan 10Share templates + tools to improve communication Moved to 2010/2011 workplan 11Update legislation to reflect new definition of capital Pending outcome of Recommendation #4 12MoHS to lead implementationOngoing 13UBCM to monitor implementation progressOngoing 8 Work Plan Update

9. RHD COST SHARING REVIEW UPDATE Work Plan for Next 12 Months Completions of Recommendations 1 and 5 Updating Recommendations 4 and 11 pending outcome of CAMF review by Govt Continuing to work on Recommendations 2, 6, 7, 8, 9, and 10 92010-09-27

10. 10 RHD COST SHARING REVIEW UPDATE Other Issues for Future Consideration Health services capital funding in Metro Vancouver RD Taxation variation from RHD-to-RHD Affordability of funding 40% share in some RHDs Sharing of capital projects in RHDs with large First Nation populations Clarity regarding role and mandate of Ministry of Finance in capital planning and oversight Long term role of RHDs in health capital funding 2010-09-27

11. 11 Comments and Questions? For updates and reports: http://www.ubcm.ca/EN/main/resolutions/policy- areas/healthy-communities.html RHD COST SHARING REVIEW UPDATE 2010-09-27