The most significant additional expense for the Simcoe Muskoka District Health Unit was wages, as casual workers were offered full-time hours and many workers worked overtime
Responding to COVID-19 will cost the local health unit more than $ 7 million this year, none of which was expected when the budget was approved in February.
Karen Ellis-Scharfenberg, CFO and vice president of program foundations and health unit finance, says she has never seen anything like COVID-19 make an impact.
“This is the change of a century,” said the 25-year-old public health veteran. “My entire career has never seen a change as dramatic as this. “
Area medical officer of health Dr. Charles Gardner said the health unit had spent the money to deal with the pandemic.
“We did what we had to do,” said Gardner. “We have considerably exceeded – enormously, really – what we had planned for the year. We had a budget that would not have explained anything that happened with the activity from March to June. “
The health unit spent beyond its means.
“COVID has had a dramatic impact on our budget … (and) the costs have put us in the red,” said Ellis-Scharfenberg. “We are not on budget … it has affected everything from our occupancy (cleaning) costs to our salary costs.”
This week, Simcoe Muskoka District Health Unit staff presented a revised – or rather revised – budget to the board of directors for approval.
By far, the biggest expense for the health unit has been salaries.
In addition to redeploying most of its staff to COVID-19 – contact tracing, case tracking, telephone answering machines – the health unit provided casual workers with full-time hours and many also started doing overtime.
New employees have been hired for IT support, contact tracing and case tracking. The health unit has also started operating its telephone lines seven days a week with extended hours.
Ellis-Scharfenberg says staff estimate that the cost of the COVID-19 response this year will include approximately $ 4.38 million in wages for redeployed staff and an additional $ 2.5 million in salary costs plus approximately $ 220,000 in social advantages.
The health unit is also facing declining revenues it would typically receive from the province for operating programs such as the Ontario Healthy Smiles dental program or school-based vaccination clinics.
Even if the health unit did not run these programs, the staff normally paid to operate these services were still paid as COVID-19 response personnel.
“We are not like any other company where there was no work to be done, that was not the scenario for us,” said Ellis-Scharfenberg. “We still had to run our business in an emergency at a much higher volume than we are used to. “
One of the other cost increases for 2020 is personal protective equipment, or PPE.
Staff estimate that the health unit will spend another $ 150,000 on PPE in 2020.
According to Ellis-Scharfenberg, the budget for a typical year includes approximately $ 10,000 for PPE.
“It is because of the amount we need, and I can say that PPE is currently difficult to access,” she said. “And it’s expensive. “
According to the staff report to the health unit board, some PPE prices have doubled since February 2020.
IT costs have increased by $ 147,000 and this only includes equipment, not additional salary costs (these figures are included in the salary line).
This is, according to Gardner, money well spent so far.
“We managed to flatten the curve, to have a COVID-19 level cumulatively less than half the provincial rate,” he said.
The infection rate for the province is 221 cases per 100,000 people, and in Simcoe-Muskoka, the incidence rate is about 87 cases per 100,000 people.
“We have had good results and in this regard, I am delighted,” said Gardner.
Since the health unit must balance its budget each year, it will rely on promised funding from the provincial government to cover part of the $ 7 million it will spend on COVID-19 in 2020.
“The money the province has promised will be critically important to us,” said Gardner.
However, the province’s commitment is not specific. Ontario has pledged a total of $ 100 million for public health units. We do not know how this money will be distributed.
“We don’t know what Simcoe-Muskoka will get,” said Ellis-Scharfenberg.
But she did provide a “rough estimate” for the board’s briefing. Staff have calculated based on the population of the region that they will receive approximately $ 3 million in COVID-19 emergency funding from the province.
Ellis-Scharfenberg said staff had cautiously guessed and had invested $ 2.7 million in the budget briefing, which covers the additional salary costs expected for 2020.
Since the province already pays the salaries of the public health unit staff, regular staff hours that have been redeployed are also covered by the province (approximately $ 4.3 million) and the health unit has a contingency reserve from which he will have to draw approximately $ 340,000 from this year to balance the budget.
The health unit is now “repatriating” staff to their original departments, where Dr. Gardner expects them to continue to cope with COVID-related impacts, such as supporting local businesses trying reopening, inspection of swimming pools that have been closed for months, and an opioid crisis that still raged during the pandemic.
He says the health unit will still need additional staff dedicated to case and contact management and COVID-19 investigations for the region.
Ellis-Scharfenberg says it is likely that the additional salary costs for 2020 will be higher.
“Wave two and future waves will have an impact on the budget,” she said. “I guess there will be impacts in 2021 as we learn to live with COVID as the second wave progresses and a vaccine is developed. “
The health unit would also be responsible for running the mass vaccination clinics once the vaccine is approved.
“H1N1 in 2009 was the last time we responded to a pandemic with a vaccine,” she said, noting that public health was the primary provider of mass vaccination clinics that year.
“It was the last time we redeployed staff as a large group, but not for the longevity we had to do for COVID or for the same scale,” she added.
The H1N1 flu virus added approximately $ 1.1 million to the Simcoe Muskoka District Health Unit, which included supplies, salaries and immunization clinics.
“We spent this on salaries, supplies and program items between January and June of this year,” said Ellis-Scharfenberg.