To audit or not to audit--that is still the question.
District councils are taking yet another look at their request for an programmatic audit of the Northwest Health Unit as the Rainy River District Municipal Association contemplates its next move.
And at another meeting later this month, it’s hoping the Northwest Health Unit board will be on hand to answer their questions.
One answer the RRDMA is looking for is whether the health unit has to deliver the mandatory programs--including those under the new guidelines--or if municipalities can look to other agencies to provide them.
At a special meeting here Monday night, the RRDMA heard from Barb Morgan, a former member of the Health Protections Appeal Board, which hears appeals from those who had grievances with the health unit.
She also came from a 17-year nursing background, having worked for the health unit in Kenora and Fort Frances, as well as for medical services. And she’s being called to the bar in May.
Morgan told RRDMA reps there were alternatives to the health unit providing the services--as long as they met or exceeded the standards set in the new, mandatory guidelines. Those guidelines focused on sharing and liaising with other agencies.
And the word "cost-effective" was repeated a number of times, she added.
"Some of these services could be contracted out," Morgan explained. "[And] many of them are offered already and would fall within the standard that has been set."
But La Vallee Reeve Ken McKinnon, who recently was appointed to the health unit board, said finding another agency to provide a service in remote communities could be difficult.
It was those remote areas, he noted, that drove up the health unit’s costs.
But Lake of the Woods Mayor Valerie Pizey questioned why that would affect the municipal levy because the cost to deliver public health services in the unincorporated areas was to be paid for by the province.
Morgan felt that was one reason an audit would help. It would spell out exactly how much was spent for services to the unincorporated areas.
"As a taxpayer, I support the audit," she noted, explaining it would be helpful to both the service providers and the people paying for those services.
Some municipal leaders suggested including all the health services in the audit to see if there was any duplication within the district. That would have to be spelled out in the request for proposals, as would the amount the RRDMA was willing to spend.
But whether now is the right time for the audit is something municipal councils will be considering before the next meeting. Rainy River Mayor Gord Armstrong explained with the new guidelines, much could change in the next year.
"Right now we’re in transit. So what is an audit really going to do?" echoed Reeve McKinnon.
"I think our big fight is really with the provincial government," he added, noting it downloaded the responsibility for public health to municipalities and then upped the standards by putting out new guidelines.
The health unit had an audit done in 1994, he added, which led to substantial changes.
McKinnon thought that audit ran in the $800,000 range, with some $500,000 of that paid out in severance packages.