Simcoe County is tying hospital capital funding to performance.
After discussing ambulance off-load times earlier this spring, council voted this week to put its money where its mouth is: hospitals that assist the county by ensuring nurses assume care from paramedics sooner will receive their money.
Those who delay, however, won’t get all the money the Simcoe County Hospital Alliance requested on their behalf for the next decade - 2017 to 2026.
In 2015, the county held back just over $93,000 of the $3 million it sets aside each year for hospital projects.
Today, the county set the framework for another 10-year, $30-million deal – but it comes with strings attached.
Any reductions in funding will depend “on the number of infractions and the time. The county’s costs were increasing due to off-loading issues at the hospitals,” said CAO Mark Aitken.
The county bases its paramedic costs at $175.32 per hour.
And Ontario sets the patient off-load standard at 30 minutes. The county would like to see that respected.
And local hospitals have been working to moving towards that, with the phase-in beginning at 50 minutes, then 40 minutes and then 30 minutes.
However, at Barrie's Royal Victoria Regional Health Centre, patient off-load takes 55 minutes. At Soldiers' Memorial in Orillia it takes 42 minutes and at Southlake Regional Health Care Centre in Newmarket, 40 minutes.
Hospitals in Collingwood, Midland and Alliston are even faster at taking responsibility for patients arriving by ambulance and are at or near the 30-minute standard.
Over the first 10 years of County funding, RVH received the lion’s share, $20 million towards the expansion that included the Simcoe Muskoka Regional Cancer Centre and an expanded emergency department.
Looking ahead, hospitals across the region are looking at expansions or upgrades, the largest projects being including a new hospital in Collingwood, an expansion at Southlake Regional Health Centre in Newmarket and another capital project at RVH.
As well, the county policy restricts hospital foundations from asking local municipalities for funding.
The county asked the hospitals to work together to create a unified ask, as provincial funding for projects became more dependent on local support.
“The hospital alliance doesn’t have a board. It was created by the county,” Aitken said, noting hospital presidents make up the board, which prioritises projects and makes a unified ask from the county.
“It’s a meaningful discussion by the hospitals in the region as to where the money should go.”
Yet hospital and hospital foundation officials continue to ask their local governments for cash, he noted.
“The local portion is covered. The (agreement) limits the hospitals, hospital foundations and fund raisers from putting pressure on municipalities,” said Aitken.
Mayors, councils and municipalities, however, could opt to participate in golf tournaments or special events that support their local hospital, but any formal ask for project funding would not e allowed under the policy, he explained.