HHHS deficit adds to ‘very challenging year’

The following are brief reports from the Haliburton Highlands Health Services board meeting held virtually on Dec. 2.

By Sue Tiffin

When giving a financial overview, David O’Brien, vice-chair of the board and chair of the finance committee, noted “two very large numbers facing us right now.”
“We’re experiencing a second very challenging year with a deficit of about $613,000 as of Sept. 30,” he said. “Similar to last year, ongoing staffing pressures of about $350,000 and total lost revenue from Ministry of Health sources of about $372,000 explain the majority of the unfavourable variance to date.”
“In addition, we’re experiencing cashflow issues,” he said. “Like all hospitals we have not received our reimbursements for COVID-related expenses since the end of February of this year, and those expenses are now approaching $3 million.”
O’Brien said COVID expenses are approved separately and reviewed by the province.
“We’re going to continue to have serious issues going forward in the year, I don’t know what the third quarter numbers are going to look like but they’re not going to be pretty, for sure,” he said. “We will continue to work with our funding agencies to help them understand our challenges. These challenges are particularly onerous on a small rural hospital. All hospitals are facing these kinds of issues, obviously, but they’re particularly onerous on small rural hospitals who have very limited sources of external revenue that they can depend upon.”
O’Brien thanked staff, including CEO Carolyn Plummer, doctors, nurses, healthcare professionals, and those working at the hospital for their work.
“We are working under severely difficult and stressful times,” he said. “Our financial issues do nothing more than add to the already stressful times.”

Plans for emergency department closure ongoing
A decision on which emergency department in the county will see a service reduction has not yet been made.
“First, patient and staff safety has been and will continue to be at the forefront of our discussions and analysis,” Plummer later told the Echo. “We will also continue to be led by our values of compassion, accountability, integrity, and respect. To make the difficult decision about which ED may have to reduce services, we are considering: typical volumes of patient visits to each emergency department; current staff schedules, gaps, and staffing models; the geographic location of each emergency department in relation to communities across Haliburton County; and feedback from our partners, including but not limited to the Ministry of Health, Ontario Health East, and Haliburton County Paramedic Service.”
In the meantime, Plummer said a service reduction is still trying to be avoided, with attempt to recruit permanent staff or temporary staff.
“But we know the staffing shortage we’re experiencing is definitely significant across the entire province, so we do have to plan for all circumstances and be prepared for all circumstances,” she said. Once it is decided which site will experience potential closures, Plummer said the public will be informed at least 48 hours prior to the closure.
“While our emergency departments typically see their greatest volumes during the summer months, visits also increase during the fall and winter as respiratory illnesses circulate in the community,” she told the Echo. “With this in mind, and with the recent rise in COVID-19 cases, we strongly encourage community members to follow public health measures, including frequent handwashing, wearing a face mask in public spaces, and maintaining social/physical distancing. We will continue to do everything we can to recruit new staff, support our existing staff, and engage with staffing agencies to help fill gaps until more staff can be hired.”

HHHS preparing for Omicron
Plummer said that just when it started to look like pandemic-related challenges were slowing down, the new variant of concern has caused “heightened awareness.”
Measures in place to prevent the spread of COVID-19 have continued, though with the news of the Omicron variant, Plummer said there are changes to screening questions, specifically asking about travel.
Plummer spoke to the outbreak of student cases related to a bus route, which at press time involved five students from SBES and JDHES.
“We have been seeing some increased volume of cases in our community, and an increased volume of folks looking for testing at our assessment centre,” said Plummer.
To date, HHHS staff has a rate of 97.4 per cent for those who are fully vaccinated or have had at least one dose of the vaccine and are being tested regularly.
“I think everybody’s really hoping this will end soon,” she said.

Long-term care changes welcomed
Plummer spoke to proposed changes to long-term care legislation, noting the Providing More Care, Protecting Seniors, and Building More Beds Act, 2021, which if passed would repeal the current Long-Term Care Homes Act, 2007, and create the Fixing Long-Term Care Act, 2021.
The proposed bill includes an increased focus on direct care hours available per resident, which has been announced previously, different compliance and enforcement tools, a bigger focus on improved infection prevention and control and a focus on quality improvement for LTCs.
HHHS manages two long-term care facilities – Hyland Crest and Highland Wood – and Plummer said they were welcoming the revised legislation.
“Hopefully that will lead to some more positive changes in that sector, something we’ve been certainly advocating for some time, and will continue to do so,” she said.

Foot care program returns
Plummer’s report to the board noted that community clients “are very excited about the return of the foot care program.”
The wait list had included more than 250 people, who have all been contacted for appointments. The program is being offered at the HHHS Minden site, and will be reopening at the Haliburton location soon.