Hospital districts across B.C. are asking the province to update the 1996 Hospital District Act (HDA), so it better reflects 21st century practices.
The West Kootenay-Boundary RHD (regional hospital district) board recently agreed it’s time to modernize the statute and join the initiative, especially as the annual Union of BC Municipalities (UBCM) nears.
“There has been a concern expressed at the Regional Hospital District board about elements of the Hospital District Act which are not consistent with current practices,” Trail Mayor Mike Martin told the Times.
“And in fact, in some cases, there needs to be some reconsideration.”
The topic came up after the 30-member board received a direct request from the Comox Strathcona Regional Hospital District that they support updating the act, and that the matter be advanced to the Ministry of Health (MoH).
Martin says the motion passed unopposed.
“Each RHD in the province received a letter from Comox Strathcona RHD, with a request to join them in support of the two recommendations,” said Martin.
“The West Kootenay-Boundary RHD unanimously supported the above two elements,” he added.
“Also, there is a letter from the MoH supporting the need of updating the Hospital District Act to reflect current practices and (it) will be recommending the necessary changes in the near future.”
In the meantime, Martin said there is no expectation that hospital districts will need to change current practices.
He mentioned three specific areas of the Act – legislative policy, tax rates, and language – to exemplify sections in need of aligning and modernizing.
For instance, each year regional hospital districts budget for capital expenditures, such as new equipment or repair of certain infrastructure.
Historically, taxpayers dollars are not used for costs to operate hospitals and facilities, such as staffing.
“With regard to the funding formula, the concern has been with regard to RHD being asked to consider funding for operating needs as part of the cost sharing,” Martin said.
“The need for clarification, as in the view of the RHD cost sharing, should be limited to construction and capital equipment.”
Tax rates also need to be amended, he said.
“To enable RHD’s to set the appropriate tax rate to reflect the local hospital district funding priorities.”
Additionally, within the current Act, there is no clear definition of the facilities eligible for funding, Martin added.
“(It) seems to be all over the map with regard to acute and residential care.”
As the 2017 UBCM nears, Martin says the City of Trail will be requesting meetings with both the Ministry of Health and Interior Health.
The primary purpose of the West Kootenay-Boundary RHD is to provide funding for hospital equipment and capital projects, with the board determining how much local taxpayers will contribute annually.
Projects are proposed by Interior Health (IH) each year, then a priority list is developed in consultation with the regional hospital district board.
The hospital district typically pays 40 per cent of the cost for approved projects, while the remaining 60 per cent is funded by the province or through donations from local hospital foundations.
Notably, in 1967, through adoption of the Hospital District Act, regional districts were given responsibility for regional hospital capital financing.
This was enacted in large part, to introduce fairness in access to health services. For example, until that time, municipalities paid for all of the capital costs of respective hospitals, even though people living outside city boundaries benefited.
Similarly, small rural hospitals or diagnostic and treatment centers had to be financed by local improvement districts which varied greatly in terms of their financial capacity.