Thursday 2 May 1991

Subcommittee report



Chair: Callahan, Robert V. (Brampton South L)

Vice-Chair: Poole, Dianne (Eglinton L)

Bradley, James J. (St. Catharines L)

Conway, Sean G. (Renfrew North L)

Cooper, Mike (Kitchener-Wilmot NDP)

Cousens, W. Donald (Markham PC)

Haeck, Christel (St. Catharines-Brock NDP)

Hayes, Pat (Essex-Kent NDP)

Johnson, Paul R. (Prince Edward-Lennox-South Hastings NDP)

MacKinnon, Ellen (Lambton NDP)

O'Connor, Larry (Durham-York NDP)

Tilson, David (Dufferin-Peel PC)

Clerk: Manikel, Tanis

Staff: McLellan, Ray, Research Officer, Legislative Research Service

The committee met at 1024 in room 228.


The Vice-Chair (Ms Poole): I would like to open up this session of the standing committee on public accounts. The first section of the agenda will be in public and we will then go into closed session for discussion of our university audits report.

First of all, a report of the subcommittee. Ms Haeck, Mr Cousens and myself were all present at the steering committee meeting. Our conclusion for consideration of the full committee was that we would like to look at section 3.13 of the Provincial Auditor's report, which related to OHIP billing and drug and alcohol treatment centres.

Under drug and alcohol treatment centres it was suggested that we look at availability, effectiveness, other treatments that are available, health dollars spent in the United States and models in other jurisdictions. That is something I would like to open up for discussion by committee members: whether you concur with the subcommittee that this is an area you would like to explore. Any comments?


The Vice-Chair: Perhaps it would help if the auditor could comment on the section of his report that talked about OHIP billings and the drug and alcohol treatment centres.

Mr Archer: Yes. This subject matter was just one aspect of the section 3.13 that was in last year's auditor's report. We had a look at the out-of-province payments that were being made as to the efforts being made to control them and satisfy themselves that the right amounts were being billed and that sort of thing. The ministry had taken a lot of good initiatives in that area. We also got very briefly into the drug and alcohol addiction aspect and we noted that in 1990 the out-of-province treatment of those two addictions accounted for $20 million of the OHIP expenditure, which was up from a figure of $7 million in the previous year. So it certainly is a significant jump.

We pointed out that the branch involved with OHIP was concerned that US hospitals were luring patients from Ontario and that selling aspects included paying patients' air fare to and from the US site and limousine service from the airport to the hospital, to and from. It was that type of abuse, if you like, at the time of our audit, that caused the ministry to delay payment on some $500,000 worth of claims from US hospitals because it thought they had been inflated for one reason or another. Certainly there was a recognition in the ministry that the process was wide open to abuse and they were attempting to come to grips with some of it as best they could. I think that is probably what triggered some of the members in suggesting that this drug and alcohol treatment centre feature be explored more thoroughly and the reason why it is on the agenda.

For perspective, if we are just dealing with the out-of-province aspect of it, the total amount spent in the 1990 fiscal year for out-of-province health care was $120 million. Of that, $20 million was for drug and alcohol addiction treatment. While that number is large, let us bear in mind the total of the Health budget, which is $15 billion or $16 billion, out of which $7 billion or $8 billion would be for hospital treatment, and maybe $4 billion or $5 billion for medical treatment, so we are talking billions on one hand and $120 million on the other. While effecting economies for drug and alcohol treatment would certainly be beneficial, it is not going to make a major dent in the overall health care expenditure.

The Vice-Chair: That gives us some background information to operate under. Does anybody else have a comment about the possibility of the committee's looking at OHIP billings and drug and alcohol treatment centres?

Mr Cousens: I move approval.

The Vice-Chair: Mr Cousens moves approval of this item.

Motion agreed to.


The Vice-Chair: I suppose the other thing that has to be considered is timing. The clerk has prepared a tentative agenda for the month of May, which, as you can see, centres on getting to the draft report stage for our university audits and our school board audits. It is quite possible that these two items themselves would be sufficient to take us to the end of the June session, so we would probably be talking about the next item if we proceed with the OHIP billing and the drug and alcohol treatment centres some time in the summer, whenever the House leaders would allocate us time.

We do have discussion of the committee budget next, and it is probably just as well we discuss that now so we can do it in tandem with the decision that has just been made. If you take a look at the budget you will note that, although travel has been put into the budget for the two conferences in Winnipeg and Montreal, we have heard rumours that there will not be any travel outside the province, so this is obviously still quite tentative.

The second item is that we have not accounted for any travel arrangements within Ontario for committee hearings that might be held on the OHIP billings and the drug and alcohol treatment centres, so that is something to keep in mind.

Ms Haeck: Just a quick question. You mentioned about the select committee on education being denied the ability to do the kind of travel that it wanted, but has this particular committee had a history of doing travel on other issues in other years?

Clerk of the Committee: The committee has travelled not too much recently, but a couple of years ago we travelled through Ontario for one week to go to firefighting centres and psychiatric hospitals. We were doing two different studies, and we were able to combine the two, if you like. The day was very different, because you would start off with one in the morning, and have the other in the afternoon, and then reverse it the next day, but we managed.

The committee has put in for a trip to Europe to study how other countries set up this type of accounting system with public accounts committees or a similar structure. That has been denied in the past, and I cannot really think of anything else. I know the committee did travel to Washington and to Ottawa at the start of the last Parliament, again to compare how other jurisdictions do their public accounting, and I think members found that quite useful.

The Vice-Chair: That was before I went on the committee. I can assure you, any committee I am sitting on will not travel beyond Thunder Bay, Sudbury, Windsor and Ottawa.

Ms Haeck: Is this a personal preference of yours?

The Vice-Chair: No, actually it was quite to the contrary, but it just seems to have always worked out that way. Even the select committee which you mentioned was actually approved by the Board of Internal Economy. It was supposed to go down to the United States for a conference. It got cancelled. I am just used to it. This committee applied to send a steering committee to Australia last year, and that obviously did not go through either.

We are basically talking about travel within Ontario. I do not think right now it is probably going to be approved to travel outside, so I would suggest that we concentrate on that. We might also discuss some possibility of travel in the United States, but I think it would have to be very limited and there would be no certainty that it would be approved by the board. It is just my recommendation that, instead of wasting a lot of time talking about travel to California, New York, Washington and so on, we perhaps concentrate on where best to go in Ontario.

Mr Bradley: You would have a hard time getting flights, because the federal members have them all booked.

The Vice-Chair: As part of their restraint program.

Mr Bradley: I could tell you an interesting story of the 1982 recession and the federal travelling plans. Have you ever noticed that your federal member has two things in his or her constituency newsletter? One is where that person has been and the other is where they are going. "Here I am at the NATO conference representing you. Here I am in South America at the elections. Here I am here." They are like the Strategic Air Command: one third of them is in the air at all times.

The Vice-Chair: That being said, where would we like to travel within Ontario, if anywhere? There are certainly several treatment centres in the greater Toronto area that I would suggest would be a good starting place. I know that in addition to Donwood, there are several others. Ray, do you have any information?

Mr McLellan: The Homewood in Guelph. I have prepared research on US clinics as well as Ontario clinics. I do not have that information with me right now. I can certainly get it to members if you would like it. I have contacted OHIP and the 12 or 13 most-used clinics in the United States. A lot of them are located in the northeastern United States, in New Hampshire and New York state.

If the committee does have limited travel, it is possible that you might consider the ones in the northeastern United States and not the ones in the central or southern United States or California, for example, in the far west.

The Vice-Chair: For instance, if we were considering going to Buffalo, for one thing nobody could honestly believe that anybody would go to Buffalo for any other reason than business.

Mr Cousens: Go for some shopping, too.

The Vice-Chair: But secondly it would be very easy to bus members there as opposed to having expensive air fare or going People's Express, whatever. It could be done in a very cost-efficient manner. That may be something we might like to consider as a second option, not necessarily a separate option, but to make our travel in the United States quite reasonable and very cheap.

Mr O'Connor: Have we looked to marketing strategies as opposed to how many centres there are in the United States?

Mrs MacKinnon: They publish it in our local papers; they publish it like crazy. I have got some statistics that are just terrible.

Mr Cousens: Along the way we will identify the top one or two or three that we want to visit that are outside Canada. Keeping in mind the guidance you are suggesting that it be economically within grounds that we could recommend to the Board of Internal Economy, I have to feel that it is the kind of investigation that is going to be warranted once we get into it because of the dollars that are being spent. In fact, who knows, we might come back with some very good lessons for Canadians to improve our system. We might see other things that need to be improved.

If there is anybody equipped to represent the people, it is this committee on public accounts. Maybe we are trying to be too fast on it. It is something that will come through our studies, and we can always go back to the Board of Internal Economy once we have decided it is worth while. I think we would definitely want to see Ontario sites. But the more I see of it, and knowing people are going to the United States, I do not have to go along with it but I would like to go somewhere.


The Vice-Chair: I think those comments are well taken. Once we have chosen the sites where we are going to go, particularly outside Ontario, if any, we might want to take a look at some of the other auditor's items and see if there is something there that we can investigate at the same time to make sure we are using taxpayers' dollars wisely and doing the most we can on our trip.

I would suggest that we leave it in the hands of the clerk and Ray, our researcher, to make up a list of the most feasible sites, both within Ontario and in the northeastern United States, and that they prepare a tentative budget with that in mind, and bring it back to us next week. It seems to me rather silly to go ahead and approve a budget that does not have any provision for travel within Ontario at all, because it is obvious that we are not going to be able to just sit in Queen's Park and learn anything on this issue. We have to go out at least to Guelph and to some places in the surrounding area. Shall we leave it at that?

Clerk of the Committee: I want clarification on another point, just to make sure everyone agrees on what I have done in the budget. In the past, the public accounts committee has not translated its committee reports into French. There is public accounts committee and, I believe, the standing committee on the Legislative Assembly; some of their reports are not translated. It has been felt that this committee's reports are available to the public, but they have not been utilized by the public, so that was the basis on which the decision was made not to translate them; it was basically an administrative document. The ministries were interested in them, other committees are interested in them, but we do not get the requests from the public. I would just like to canvass the members, if you like, to make sure that is still the feeling of the committee. If so, I will not put any money in for translation. If you feel that it should be translated, I will add that as well.

The Vice-Chair: Mr Bradley, I just wonder if you have any comments.

Mr Bradley: No, I have no comments.

Mr Cousens: Madam Chair, I support that. If there is something that comes along that is of interest to any specialized group for French translation, then I think we can ask for permission to do it, even if it would be outside the budget guidelines.

Ms Haeck: I am going to take a slightly divergent opinion here, because I have a feeling that around the issue of the drug treatment centres, you will be having a much broader audience, and while you may not wish to translate the entire document, you may look at wishing to translate an executive summary or doing up highlights or something like that, which could go to interested parties, which would obviously cross this province.

The Vice-Chair: Any other comments? One thing we could do is put in the budget without it and then see what the demand was. Ms Haeck's suggestion might be a compromise where it is fairly cost-effective and yet would get the message out. This report may generate more interest in the public than previous reports simply because it has been a very newsworthy topic lately and people are quite concerned about it.

Ms Haeck: Can I ask one little question?

The Vice-Chair: Certainly.

Ms Haeck: On page 2 of the budget, under the catering and hospitality section, I was just going to ask, we have a meals portion on page 1, and then we have catering and hospitality. I can hear a few people in my area asking questions about that kind of item and what they might see as duplication. Could you give us some clarification on the items on page 2?

The Vice-Chair: The meal per diem on the first page refers to the meal allowance that is given to members when they are serving on committee. On the second page, and the clerk can feel free to correct me if I am wrong, that refers to things like simply serving tea and coffee for all the committee hearings and that type of thing. Hospitality would refer to what?

Clerk of the Committee: In the past we have had a number of occasions where we have hosted meals, particularly for other visiting delegations, so I have left some money in for that. It could also be that if we went to another jurisdiction we might want to take some sort of present, and it is to cover that type of thing. This committee is a little bit different in that we are meeting with our counterparts in other places, and while you probably would not do this on public hearings -- it is done rarely on public hearings -- in this type of committee it might be appropriate to host a meal site for another delegation.

The Vice-Chair: Or for instance, if we were to have a delegation going to the Winnipeg conference it might bc possible that we have, for one evening, a hospitality suite, and just invited people in for hors-d'oeuvres. This money may well never be used. When you do budgets it is always wise to look at what might be incurred, not necessarily what will be incurred, and the way the system works, if there is money left over in the budget it does not get transferred to another fiscal year. You cannot use it in any way other than the purposes that we put it down for, so it is not committing the Legislative Assembly to anything.

The other thing about the catering, if you had questions from your constituents. It is taking from one hand and giving to the other, because the Legislative Assembly runs the catering, so the Legislative Assembly pays $2,000 for catering to the Legislative Assembly. So I am not really sure that there is a lot of money changing hands for tea and coffee.

Ms Haeck: I think most people appreciate having some tea and coffee available, whereas I know there are usually some queries if you are doing heavy-duty entertaining. Just to be clear that for the most part we are looking at coffee and tea for people coming to witness these hearings.

The Vice-Chair: I can assure you there is no caviar or shrimp on this committee, or anything other than tea or coffee.

Clerk of the Committee: Sometimes not even tea.

The Vice-Chair: Sometimes not even tea.

Ms Haeck: That is right, you could not even find a tea bag.

The Vice-Chair: I am willing to chip in 10 cents a time for my tea bags. I did not think it was that frivolous.

Any other comments about the document? With a view to Ms Haeck's comments about the cost of preparing a translation -- I am sorry. Mr Johnson?

Mr Johnson: I was just wondering what a typical budget would cost. What have the total budgets for the standing committee on public accounts been in the past, do you know that?

Clerk of the Committee: I would not have the figures offhand. This is fairly typical, though. Last year I think we put in for approximately the same thing. The trip for the conference of public accounts committees was to Newfoundland, so the air fare was a little bit higher. The Canadian Comprehensive Audit Foundation conference was in Ottawa, so the air fare there was a little bit less, so it basically balanced out. I do not believe we put anything in for travel, because at that time we were preparing the budget. We were anticipating the election and not meeting in the summer. As it turned out, of course, with the election being called, this much was not used, or most of it.

The Vice-Chair: I would point out that again, when you are deciding what to put in, for instance Tannis has put that we would be sitting for 17 days in the summer of 1991. It is just my experience that it is unlikely the House leaders are going to give us four weeks of hearing time just because there will be such a competition among committees to get hearing time, so we may only use half of that. We do not know what the House leaders will give us, so we have to go on the assumption of what the maximum would be. If we do not sit for 17 days, we do not use the money and it remains with the Legislative Assembly.

Mr Johnson: If I may, there is a discrepancy here, and that is the fact that the meal per diem is 17 days and the meeting per diem is 15. Is that --

Clerk of the Committee: Okay, if I can explain that. The meeting per diem is the number of days that we meet. There are two things with travel per diem. Assuming we all go to the conference in Winnipeg, members will be able to claim part of that as travel. It comes out of the same pot, and it is the same amount, but you claim it under two different things. If you are going someplace and you are not attending a meeting, the day you travel is put in as a travel day, so you get travel per diem. On days when we hold meetings, it is a meeting per diem. Those are the two different things. You can claim meal allowance, meal per diem, on both of those days under either type. If you add them together, it comes out to 17.

Mr Johnson: I understand.

Mr Cousens: You will not ask that after being here another couple of years. That is something you learn quickly.

Mr Johnson: And so have I.

The Vice-Chair: Any other comments? I think other than perhaps taking a look at Ms Haeck's point about whether we could translate an executive summary -- it would not be very costly to do a four- or five-page summary.

Clerk of the Committee: Maybe in that case I can put in a couple of thousand dollars for translation, which, even if we decided to translate the full report, depending on its size, would probably cover us. We would have it there if we decided to translate that or any other document.

Mr Johnson: Do you get a pat on the back if you present a budget and you are under your budget by several thousand dollars?

Clerk of the Committee: No.

The Vice-Chair: Maybe that is something that the public accounts committee would recommend, that they have prizes, recognition day, where they give out awards in the Legislature for the most --

Mr Johnson: Have a big award banquet and spend all the money that is left. Yes, it is a great idea.

The Vice-Chair: Well, no. I do not think they have banquets in the Legislature. I was thinking more of just handing us out a little certificate, photocopied on both sides for recycling purposes, acknowledging that we did our very best to spend the taxpayers' money wisely.

If there are no other changes recommended to the budget, then we will ask Tannis to come back next week with the tentative plans for travel both within and without Ontario. Probably logistically, if we are taking it to the Board of Internal Economy, it may be best to separate travel within Ontario from travel to the United States, just so that if it does get removed it does not create a lot of problems. But other than that and the translation, those are the only two things.

Okay, then we will leave this till next week, and unless there are any other comments we will go in camera.

The committee continued in camera at 1053.