Recommendation No. 12 Compliance with the Charitable Fund-Raising Act
We recommend that the Ministry improve its monitoring of compliance with the Charitable Fund-Raising Act.
Monitoring is limited to investigations and reviews of applications
In 2000-01, there were over 500 enquiries made to the Ministry from the public related to the Charitable Fund-Raising Act. Those
enquiries led to about forty investigations by the Ministry. In
addition to following up enquiries, the Ministry screens applications for registration by fund-raisers and does background checks of management of those organizations, including for example, criminal records checks and bankruptcy checks. As a result, monitoring is limited to an initial review of the fund-raiser when applications are received and to identify problems arising from enquiries. Fund-raisers, who are not the subject of an enquiry, are not monitored subsequent to the initial screening.
This does not constitute effective monitoring by Ministry staff. Audits of fund-raisers are required
In our view, a monitoring system that is basically complaint driven is not sufficient. Only the fund-raisers who are the subject of an enquiry may be investigated. Also, not all members of the public who have concerns about fund-raising activities will lodge a
complaint. Further, there are requirements under the Act, which the public would not be able to assess, such as record keeping. We believe that an effective monitoring system would include an audit of fund-raisers for compliance with the Act.
The Ministry should assess the risk of non-compliance in critical areas of the legislation
The Ministry agrees with our recommendation and has indicated that it plans to implement a program to audit fund-raisers for compliance with the Act. As the Ministry is responsible for ensuring effective regulatory compliance and enforcement for about 30 Acts and has limited resources available for such responsibilities, it may not be possible for the Ministry to audit all fund-raisers. Therefore, the Ministry should assess the risk of non-compliance for each
registered charitable organization and focus its inspection resources on those organizations that have the highest risk of non-compliance and for critical areas of activity, such as those subject to severe penalties.
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Ministry financial statements
I conducted an audit of the financial statements of the Ministry as at and for the year ended March 31, 2001. My audit opinion on these financial statements was issued without reservation.
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Health and Wellness
Overview
The vision of Alberta Health and Wellness (the Department) is
“citizens of a healthy Alberta achieve optimal health and well-being.”
The Department’s mission is to lead
The Department’s mission is “to maintain and improve the health of Albertans by leading and working collaboratively with citizens and stakeholders.” This recognizes a social system for health that should emphasize illness prevention and the delivery of health services. To carry out the mission, the Department defines two core businesses. These are to lead and support a system for the delivery of quality health services and to encourage and support healthy living. The intent is to promote the wellness of Albertans and not just to treat the ill and injured. Programs are to address risks to health where knowledge or early intervention can reduce demand for health care.
A complex system to manage The Minister is accountable for more than 30 Acts and for what has been achieved from the allocation of money to programs and services delivered through a regional structure. The Department’s challenge is to reconcile many stakeholder interests and orchestrate a Provincial health system through a decentralized structure.
The main entities accountable to the Minister are the Department, 17 regional health authorities (RHAs), two health boards (mental health, cancer), the Alberta Alcohol and Drug Abuse Commission (AADAC), and eight Persons with Developmental Disabilities Boards (PDD Boards). Effective March 19, 2001, responsibility for
PDD Boards was transferred to the Ministry of Community Development.
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Highest program spending Ministry
Health spending represents about 35% of total program spending of the Alberta government. A comparable expenditure profile
(unadjusted for inflation) of the Ministry is presented in this chart:
Chart 1
Trend in Alberta Health & Wellness Expenses
3,904 4,095 4,578 4,808 5,485 5,910
0 2,000 4,000 6,000 8,000
95/96 96/97 97/98 98/99 99/00 00/01 Fiscal Year
$ Millions
Readers are referred to the annual report and financial statements of the Department for details of expenses (www.health.gov.ab.ca).
Significant increase in spending
Public health spending has increased significantly. Over the past five years, per capita spending of the Department increased 28% in constant dollars and about 38% in current dollars. Expenditures are higher than they have ever been at about $1,970 per person in 2000-2001. Alberta has a relatively young population. The Department calculates that, on an age-adjusted basis, Alberta has the highest per capita health spending of all provinces.
Summary of audit results
Urgency for improved planning and control
While the Department has made some progress on audit
recommendations, implementation is slow and results are not yet apparent. There is more urgency for improved planning and control in view of increased health spending.
Authorized business plans are not in place at the beginning of the year as a basis of accountability throughout the year. Continued one-time funding is not compatible with well-managed budgets.
Better reporting of costs, outputs and outcomes is needed so that decision makers can know whether optimal results are being achieved at least cost and to support evidence-based planning and resource allocation decisions.
The Department should clarify its expectation for equipment funding. Unrestricted funding for capital equipment has deferred deficits rather than recognizing them. Stronger management of
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available resources is needed to further diminish the risk of not sustaining equipment assets.
There is opportunity to strengthen accountability for Province-wide medical services and show how to achieve better accountability for clinical and financial results.
An assessment of risks in physician payment systems should be completed and systems correspondingly further improved to prevent incorrect billings and to promote cost-effective use of resources.
The Department can better manage contracting risks by improving control to ensure compliance with policies and good practices.
Also, the process for approving surgical service contracts of health authorities can be improved in line with new legislation.
Now is the time for the Department, in cooperation with health authorities, to assess the benefits and risks in the way health information systems are developed and managed.
Because of inadequate financial reporting, my audit opinions were reserved on the financial statements of the Ministry, the
Department, various Persons with Developmental Disabilities Boards, and the Alberta Alcohol and Drug Abuse Commission.