Responding to COVID-19 will cost the local health unit more than $7 million this year, and none of those millions was planned when the budget was approved in February.
Karen Ellis-Scharfenberg, the chief financial officer and vice-president of program foundations and finance for the health unit, said she’s never seen anything make an impact like COVID-19.
“This is the change of a century,” said the 25-year public health veteran. “My entire career has never seen a change so dramatic as this.”
The region’s medical officer of health, Dr. Charles Gardner, said the health unit has been spending the money it needed to spend to respond to the pandemic.
“We did what we had to do,” said Gardner. “We went substantially over, wildly over really, what we anticipated for the year. We had a budget that in no way would have accounted for what happened with the activity from March through to June.”
The health unit has been spending beyond its means.
“COVID has had a dramatic impact on our budget … the costs have put us in the red,” said Ellis-Scharfenberg. “We are not living within our budget … it has touched everything from our occupancy costs (cleaning) to our salary costs.”
This week, staff from Simcoe Muskoka District Health Unit took a revised - or rather overhauled - budget to the board of directors for approval.
By far, the biggest expenses for the health unit has been salaries.
In addition to redeploying most of its staff to COVID-19 response – contact tracing, case follow-up, answering phone lines – the health unit offered casual employees full-time hours and many staff also started working overtime.
There were new staff hired for IT support, contact tracing, and case follow-up. The health unit also started operating its phone lines seven days per week with extended hours.
Ellis-Scharfenberg said staff estimate the cost of the COVID-19 response this year will include about $4.38 million in salaries for the redeployed staff and another $2.5 million in additional salary costs plus about $220,000 in benefits.
The health unit is also facing decreased revenue it would usually receive from the province for operating programs like the Ontario Healthy Smiles dental program or in-school vaccination clinics.
Even though the health unit wasn’t running those programs, the staff normally paid to operate those services were still paid as COVID-19 response staff.
“We’re not like another business where there wasn’t a job for them to do, that wasn’t the scenario for us,” said Ellis-Scharfenberg. “We still had to run our business in an emergency at a much higher volume than we’re used to.”
One of the other increases in costs for 2020 is personal protective equipment.
Staff estimate the health unit will spend another $150,000 on PPE in 2020. According to Ellis-Scharfenberg, a typical year’s budget includes about $10,000 for PPE.
“It’s because of the quantity that we need, and I can say PPE is currently hard 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 increased by $147,000 and that’s only including equipment, not the additional salary costs (those figures are included in the salary line).
It is, according to Gardner, money well spent so far.
“We’ve managed to flatten the curve, managed to have a rate of COVID-19 cumulatively that is under half the provincial rate,” he said.
The incidence rate of infection for the province is 221 cases per 100,000 people, and in Simcoe Muskoka, the incidence rate is about 87 cases per 100,00 people.
“We’ve had good results, and in that regard I’m pleased,” said Gardner.
Since the health unit is required to balance its budget each year, it will be relying on some promised funding from the provincial government to cover some of the $7 million it will spend on COVID-19 in 2020.
“The money the province has pledged will be critically important to us,” said Gardner.
The province’s pledge, however, is non-specific. Ontario promised $100 million for public health units in total. There’s been no word on how that money will be split.
“We don’t know what Simcoe-Muskoka will get,” said Ellis-Scharfenberg.
But she did provide a “guesstimate” for the board briefing. Staff calculated, based on the population of the region, they would get about $3 million in COVID-19 emergency funding from the province.
Ellis-Scharfenberg said staff guessed conservatively and put $2.7 million in the budget briefing, which covers the additional salary costs expected for 2020.
Since the province already pays the salaries for public health unit staff, the regular staff hours that were redeployed are also covered by the province (about $4.3 million) and the health unit has a contingency reserve it will need to draw about $340,000 from this year to balance the budget.
The health unit is now “repatriating” staff back to their original departments, where Dr. Gardner expects they’ll still be dealing with COVID-related impacts like supporting local businesses trying to reopen, inspecting pools that have been closed for months, and an opioid crisis that still rages during the pandemic.
He said the health unit will still need extra staff dedicated to case and contact management and COVID-19 inquiries for the region.
Ellis-Scharfenberg said it’s likely the additional salary costs for 2020 will be higher.
“Wave two and future waves will impact the budget,” she said. “I suspect there will be impacts in 2021 as we learn to live with COVID as a wave two progresses and as a vaccine is developed.”
The health unit would also likely be responsible for running mass vaccination clinics once a vaccine is approved.
“H1N1 in 2009 was the last time we responded to a pandemic with a vaccine,” she said, noting public health was the lead provider of mass vaccination clinics that year.
“That was the last time we redeployed staff as a large grouping, but not for the longevity we’ve had to do for COVID or to the same scope,” she said.
H1N1 brought additional costs of about $1.1 million for Simcoe Muskoka District Health Unit, and that included supplies, salaries, and vaccine clinics.
“We have spent that in salaries, supplies, and program items between January and June this year,” said Ellis-Scharfenberg.
