Alberta
Audit of supervised consumption site in Lethbridge uncovers $1.6 million unaccounted for
From the Province of Alberta
ARCHES audit finds serious financial mismanagement
Senior executive made $342,943 in 2019
The province has released the audit of the ARCHES supervised consumption site in Lethbridge and as a result of its findings, will be ending its grant funding agreement with the organization.
The independent accounting firm Deloitte conducted a grant expenditure audit after the Alberta government learned of possible financial irregularities within the ARCHES organization.
The review substantiated allegations of asset and funding misappropriation, non-compliance with grant agreements, and inappropriate governance and organizational operations. The ARCHES organization was found to have seriously mismanaged taxpayer funds meant for the most vulnerable in our society.
“It is disturbing and extremely disappointing to me that taxpayer funds allocated to this organization in order to serve the most vulnerable in Lethbridge would be used for European conferences, expenses for retreats, entertainment and gift cards. Our government will not stand idly by while millions in taxpayer funds are missing or misappropriated.”
Jason Luan, Associate Minister of Mental Health and Addictions
Below is a summary of the audit’s findings:
$1,617,094 unaccounted for due to missing documentation for expenditures from 2017 to 2018.
$13,000 of interest off ARCHES bank accounts was used to fund parties, staff retreats, entertainment and gift cards.
A senior executive’s compensation totalled $342,943 for calendar year 2019. This includes $70,672 in overtime for fiscal year 2019-20. The grant agreement allows for a salary of $80,000.
The Everyone Comes Together (ECT) program staff salaries and benefits also exceeded the amount allocated by the grant agreement by $16,000.
The number of ARCHES employees is greater than allowed by the grant agreement. ARCHES maintained up to 126 employees. However, the exact number could not be verified.
$4,301 spent on European travel for management to attend a conference in Portugal.
Thousands of dollars in unverifiable travel expenses, including trips charged to company credit cards but not recorded in the ledger.
A senior executive’s family member was hired, earning $9,900. The auditors could not locate a resume or personnel file to verify any qualifications.
$7,557 for management retreats, including meals and mileage where documentation for spending was unclear.
The grant agreement requires the organization to maintain the funding received from Alberta Health within a separate bank account; however, the audit revealed that it was comingled with other funding sources. As a result of ARCHES comingling their accounts, the auditors could not verify thousands of dollars of expenses.
Proper personal conflict of interest declarations were not recorded when related individuals or vendors were hired or utilized.
Vendors were repeatedly secured in secrecy with a lack of transparency and accountability.
No petty cash reconciliations have been completed.
$1,129 was used to buy gift cards for board members for The Keg, iTunes, Boston Pizza, Earls, Gap, Shell, Chapters, Cineplex, Amazon, Starbuck’s, Tim Hortons, MasterCard, and Bath and Bodyworks. The expense was recorded as “Gift cards – Board Members.”
$2,100 was spent on gift cards to The Oil Changer – a business owned by a senior executive’s spouse.
$2,205 was spent on a television with no receipt documentation to support the purchase.
The auditors were unable to complete the grant expenditure review in respect to all allegations received or provide a complete financial value attributable to each allegation, due to the state of ARCHES’ records and the related outstanding documents.
Due to missing funds and unverifiable transactions, as well as allegations, which could not be investigated in the scope of this audit, government will consult with law enforcement to determine whether further investigation is warranted.
To ensure people struggling with addiction can continue to receive services, government has asked Alberta Health Services to set up a temporary mobile overdose prevention site in Lethbridge with the goal of seamlessly transitioning services. Government will also be adding three recovery coaches to the region to assist in expediting individuals into treatment.
Quick facts
ARCHES has received more than $14.4 million in taxpayer dollars over the past two years.
In June, government announced an additional $4 million over four years to expand access to the virtual opioid dependency program to allow Albertans to use telehealth technology to access treatment for opioid use disorder.
Also announced was the opioid agonist therapy gap coverage program to cover the costs of medications to treat opioid use disorder for Albertans waiting to receive coverage through a supplementary health benefit plan.
As part of the $140-million mental health and addiction commitment to create 4,000 spaces, government has announced additional treatment spaces at Poundmaker’s Lodge Treatment Centres, Sunrise Healing Lodge, Fresh Start Recovery Centre, Thorpe Recovery Centre, and the Blood Tribe Bringing the Spirit Home detox centre.
From the Fraser Institute
On Monday, the Smith government announced that beginning next year it will change the way it funds surgeries in Alberta. This is a big step towards unlocking the ability of Alberta’s health-care system to provide more, better and faster services for the same or possibly fewer dollars.
To understand the significance of this change, you must understand the consequences of the current (and outdated) approach.
Currently, the Alberta government pays a lump sum of money to hospitals each year. Consequently, hospitals perceive patients as a drain on their budgets. From the hospital’s perspective, there’s little financial incentive to serve more patients, operate more efficiently and provide superior quality services.
Consider what would happen if your local grocery store received a giant bag of money each year to feed people. The number of items would quickly decline to whatever was most convenient for the store to provide. (Have a favourite cereal? Too bad.) Store hours would become less convenient for customers, alongside a general decline in overall service. This type of grocery store, like an Alberta hospital, is actually financially better off (that is, it saves money) if you go elsewhere.
The Smith government plans to flip this entire system on its head, to the benefit of patients and taxpayers. Instead of handing out bags of money each year to providers, the new system—known as “activity-based funding”—will pay health-care providers for each patient they treat, based on the patient’s particular condition and important factors that may add complexity or cost to their care.
This turns patients from a drain on budgets into a source of additional revenue. The result, as has been demonstrated in other universal health-care systems worldwide, is more services delivered using existing health-care infrastructure, lower wait times, improved quality of care, improved access to medical technologies, and less waste.
In other words, Albertans will receive far better value from their health-care system, which is currently among the most expensive in the world. And relief can’t come soon enough—for example, last year in Alberta the median wait time for orthopedic surgeries including hip and knee replacements was 66.8 weeks.
The naysayers argue this approach will undermine the province’s universal system and hurt patients. But by allowing a spectrum of providers to compete for the delivery of quality care, Alberta will follow the lead of other more successful universal health-care systems in countries such as Australia, Germany, the Netherlands and Switzerland and create greater accountability for hospitals and other health-care providers. Taxpayers will get a much better picture of what they’re paying for and how much they pay.
Again, Alberta is not exploring an untested policy. Almost every other developed country with universal health care uses some form of “activity-based funding” for hospital and surgical care. And remember, we already spend more on health care than our counterparts in nearly all of these countries yet endure longer wait times and poorer access to services generally, in part because of how we pay for surgical care.
While the devil is always in the details, and while it’s still possible for the Alberta government to get this wrong, Monday’s announcement is a big step in the right direction. A funding model that puts patients first will get Albertans more of the high-quality health care they already pay for in a timelier fashion. And provide to other provinces an example of bold health-care reform.
Nadeem Esmail
Senior Fellow, Fraser Institute
From the Montreal Economic Institute
Alberta’s move to fund acute care services through activity-based funding follows best practices internationally, points out an MEI researcher following an announcement made by Premier Danielle Smith earlier today.
“For too long, the way hospitals were funded in Alberta incentivized treating fewer patients, contributing to our long wait times,” explains Krystle Wittevrongel, director of research at the MEI. “International experience has shown that, with the proper funding models in place, health systems become more efficient to the benefit of patients.”
Currently, Alberta’s hospitals are financed under a system called “global budgeting.” This involves allocating a pre-set amount of funding to pay for a specific number of services based on previous years’ budgets.
Under the government’s newly proposed funding system, hospitals receive a fixed payment for each treatment delivered.
An Economic Note published by the MEI last year showed that Quebec’s gradual adoption of activity-based funding led to higher productivity and lower costs in the province’s health system.
Notably, the province observed that the per-procedure cost of MRIs fell by four per cent as the number of procedures performed increased by 22 per cent.
In the radiology and oncology sector, it observed productivity increases of 26 per cent while procedure costs decreased by seven per cent.
“Being able to perform more surgeries, at lower costs, and within shorter timelines is exactly what Alberta’s patients need, and Premier Smith understands that,” continued Mrs. Wittevrongel. “Today’s announcement is a good first step, and we look forward to seeing a successful roll-out once appropriate funding levels per procedure are set.”
The governments expects to roll-out this new funding model for select procedures starting in 2026.
* * *
The MEI is an independent public policy think tank with offices in Montreal, Ottawa, and Calgary. Through its publications, media appearances, and advisory services to policymakers, the MEI stimulates public policy debate and reforms based on sound economics and entrepreneurship.
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