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Report To: General Government Committee
3, 2024June Report Number: FSD-029-24
Trevor Pinn
Trevor Pinn, Deputy CAO/Treasurer, Finance and Technology
Mary-Anne Dempster, CAO
By-law Number:
Date of Meeting:
Authored by:
Submitted By:
Reviewed By:
File Number:
Report Subject: Physician Recruitment
Recommendations:
1.That Report FSD-029-24, and any related delegations or communication items, be
received;
2.That Staff be directed to execute the Memorandum of Understanding with the
Region of Durham, to the satisfaction of the Deputy CAO/Solicitor, substantially in
the form as attached in Attachment #1;
3.That the remaining funds from the approved $100,000 in the 2023 budget for
physician recruitment be used to meet the Municipality’s obligations to the Region of
Durham under the regional recruitment program;
4.That Staff be directed to create an incentive program which provides up to $25,000
per doctor, based on matching contributions from medical offices in a form similar to
the Pilot Program in the Town of Whitby;
5.That an additional $250,000 be approved to be drawn from the Economic
Development Reserve Fund to fund the incentive program for up to 10 doctors; and
6.That all interested parties listed in Report FSD-029-24 and any delegations be
advised of Council’s decision.
Resolution Number: GG-110-24
Municipality of Clarington Page 2
Report FSD-029-24
Report Overview
This report is an update to Council on local physician recruitment attraction and incentive
programs under development in the Region of Durham. The Region of Durham is focusing
on attracting family physicians to locate within the Region in partnership with Lakeridge
Health and Queens University, this work is focused on bringing family doctors broadly to the
Region.
A separate initiative being proposed is a local incentive program to attract physicians locally
to Clarington medical clinics. There is a broad family physician shortage across the
Province, and it is key that the Municipality work to bring doctors to one of the fastest-
growing municipalities in the Province to ensure that we maintain the quality of life that
residents expect of a growing municipality.
1. Background
1.1 During the 2023 Budget deliberations, Council amended the proposed budget by adding
the following resolution:
That the 2023 Budget be amended to provide $100,000 for Physician Recruitment
funded by the Economic Development Reserve Fund; and
That Staff report to Council on the framework, goals, objectives and processes for this
recruitment prior to any funding being provided.
1.2 This report outlines two funding requests which meets the Strategic Priority of Council to
facilitate local physician recruitment, one on a regional basis and one more locally
focused.
2. Region of Durham Update
2.1 At its meeting of January 17, 2024, the Region of Durham Committee of the Whole
approved Report #2024-COW -3 Family Physician Recruitment Program. This report
recommended the creation of a Region of Durham wide program to attract and retain
family medicine trainees and physicians to the Region as well as the hiring of a full-time
recruiter.
2.2 This report recommended the creation of a Region of Durham-wide program to attract
and retain family medicine trainees and physicians to the Region, as well as the hiring of
a full-time recruiter.
2.3 Durham Region is facing a shortage of approximately 145 family physicians,
representing approximately 180,000 residents. It is anticipated that the new Queen' s -
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Report FSD-029-24
Lakeridge MD Family Medicine trainee program will bring 20 new trainees to the area
each year. During this time, the attraction program will work to ensure that these
trainees choose to stay in the Region after the completion of their training.
2.4 The proposed program is not an incentive program; it is geared more towards promoting
the Region as a place to work and live and assisting with programs such as school and
job information for doctors' families.
2.5 The Region of Durham has proposed a Memorandum of Understanding, see
Attachment #1, for cost sharing with the municipalities in the Region. The total program
cost would be $225,000, plus inflation, and would be shared on a population-based
allocation.
2.6 The Municipality of Clarington would provide $3,960 for the remainder of 2024 and
$16,200 in 2025. The 2026 and 2027 allocations would be subject to the inflationary
index of CPI+2%.
2.7 It is recommended that the Municipality participate in this program on a Regional basis,
as any doctors attracted to the area could provide capacity within the Region to assist
with the shortage of family physicians.
3. Local Proposal
3.1 Staff have been approached by The Clarington Board of Trade (Sheila Hall) and Dr.
Stone, who represent local physician recruitment priorities. They have proposed a
model similar to the physician recruitment strategy employed by the Town of Whitby and
the Oshawa Clinic (which is currently relocating its 117 King Street site to Whitby).
3.2 In 2023, Whitby Report CAO-20-23 recommended $300,000 be used from reserve
funds to pilot a Family Physician Recruitment Incentive Partnership Pilot Program. Of
this funding, $250,000 would be used to provide incentives to the physicians , and
$50,000 would be used for the operating costs of the program. This would provide
$500,000 to 10 physicians over a five-year term, equally shared between the Town and
the clinic. This would provide $500,000 to 10 physicians over a five-year term, equally
shared between the Town and the clinic.
3.3 The local proposal would see the municipality provide a $25,000/doctor incentive paid
upfront upon the successful recruitment of a family physician to the clinic located at 222
King Street in Bowmanville. The clinic would also provide $25,000/doctor, for a total
incentive of $50,000/doctor.
3.4 It is suggested that the incentive be provided upfront, as new doctors have set up costs
for new practices, and the first few months after school are financially the hardest. The
Municipality of Clarington Page 4
Report FSD-029-24
agreement would require that the funds be paid back if the doctor leaves within five
years.
3.5 Each new doctor would be required to roster 1,000 patients to receive the grant. There
is no ability for the Municipality to require that these patients all be from Clarington;
however, given the location of the clinic a greater proportion of the patients are likely to
be local.
3.6 The recently announced Bill 185 includes proposed wording which would allow
municipalities to incent prescribed individuals and businesses in spite of the “bonusing
rules” in S.107 of the Municipal Act to meet Provincial priorities. It is anticipated that one
of the prescribed businesses will be family physicians/healthcare as this was used as an
example in Provincial releases. If this is the case, it would be suggested that the
agreement be between the Municipality and the clinic who would then be able to have
the employment agreement with the physicians. This would streamline funding as
agreements would not need to be entered into between the Municipality and each
doctor. An alternative would be similarly to provide the funding to CBOT , which
facilitates the funding to the doctors and clinics.
3.7 While the clinic at 222 King Street East has approached the Municipality, staff recognize
that several other medical clinics in Clarington serve residents. Staff would suggest that
any program contemplated be available to local clinics that meet the same requirements
(five years, 1,000 patients, equal funding by the clinic).
3.8 If the funding model is approved by Council, staff would draft the required agreements
to provide funding to participating clinics.
4. Financial Considerations
4.1 The Municipality has established a reserve fund that has been used in the past to
facilitate physician recruitment. As of December 31, 2023, the Economic Development
reserve fund had a balance of approximately $717,500. These funds, less amounts
already committed to Physician Recruitment through the 2023 budget process, would be
the source of funding for any approved program. At December 31, 2023, the available
balance of the reserve fund was $632,500.
4.2 During the 2023 Budget process, Council approved $100,000 to be earmarked for
Physician Recruitment. To date, $20,000 has been spent.
5. Strategic Plan
5.1 This Report addresses priority C.2.1 of the 2024-27 Strategic Plan “Support efforts to
improve access to medical practitioners and health care services.
Municipality of Clarington Page 5
Report FSD-029-24
5.2 Specifically, it addresses the identified actions to “Partner with the Region of Durham to
create a Family Physician Recruitment Program” and “Connect with local health care
providers to advocate for increased access to services”.
6. Concurrence
This report has been reviewed by the Deputy CAO/Solicitor, Legislative Services and
Deputy CAO, Planning and Infrastructure Services who concur with the
recommendations.
7. Conclusion
It is respectfully recommended that Council approve the signing of the MOU with the
Region of Durham and provide direction for Staff to create a local incentive program for
Clarington-based clinics based on similar requirements to the Town of Whitby.
Staff Contact: Trevor Pinn, CPA, CA, Deputy CAO/Treasurer, 905-623-3379 x2602 or
tpinn@clarington.net.
Attachments:
Attachment 1 -– Draft Memorandum of Understanding with the Region of Durham
Interested Parties:
The following interested parties will be notified of Council's decision:
Region of Durham
Dr. Stone
Clarington Board of Trade
Attachment 1 to FSD-029-24
1
Family Physician Recruitment Program: Memorandum of Understanding
This purpose of this memorandum of understanding, dated 24 May 2024, is to guide
discussions to fund, create and deliver a family physician recruitment program in
Durham, with costs shared between the following municipalities:
The Regional Municipality of Durham (the “Region”);
The Corporation of the Town of Ajax (“Ajax”);
The Corporation of the Township of Brock (“Brock”);
The Corporation of the Municipality of Clarington (“Clarington”);
The Corporation of the City of Oshawa (“Oshawa”);
The Corporation of the City of Pickering (“Pickering”);
The Corporation of the Township of Scugog (“Scugog”);
The Corporation of the Township of Uxbridge (“Uxbridge”); and
The Corporation of the Town of Whitby (“Whitby”).
At its meeting on 31 January 2024, Durham Regional Council endorsed the
recommendations in Report #2024-COW -3 to create a Region-wide Family Physician
Recruitment Program to attract and retain family medicine trainees and family
physicians to Durham and to fund the Durham Ontario Health Team to hire a full-time
permanent family physician recruiter (the “Program”),with core funding expenses
shared between the Region and local municipalities, and to report on that arrangement
to Durham Regional Council.
The proposed funding model for the Program between 1 July 2024 and 31 December
2027 provides for a maximum cost of $55,000 in 2024, increasing to $225,000 in 2025
and indexed to inflation plus 2 per cent in 2026 and 2027.
Each municipality recognizes that its council approval may be required to take part in
such a cost-sharing arrangement, and that any arrangement that results from these
discussions might take the form of a binding agreement between one or more parties
and the Durham Ontario Health Team.
1. The parties acknowledge that the discussions and their respective plans are
preliminary. Each party’s participation in this cost-sharing arrangement is
subject to the condition that that party receives its council’s approval or
delegated authority for
(a) this memorandum of understanding;
(b) a funding agreement with the Durham Ontario Health Team, and
(c) budget approval in each of 2024, 2025, 2026 and 2027 for any funds disbursed
or scheduled to be disbursed.
2. The parties intend to fund the Program costs according to the table attached to
this memorandum of understanding (attachment 1). The Program cost on
which each party’s proportionate share is based will be adjusted as of 1 January
2026 and as of 1 January 2027, calculated according to this formula:
Attachment 1 to FSD-029-24
2
N = (1+ (I + 2 %)) × 225,000
In this formula, the following applies:
N = the total Program cost, in dollars
I = the average year-over-year percentage growth in the all-items Consumer
Price Index for Ontario published by Statistics Canada for the then most recent
year
3. The parties intend to discuss, among other things, how that Program’s success
will be measured, the contents of a binding agreement with the Durham Ontario
Health Team, and oversight of that Program and that binding agreement.
4. The parties intend that any discussions will take place in good faith. Each party
shall make reasonable efforts to engage in the discussions competently and
promptly.
5. The parties are not prohibited from negotiating with from anyone else or from
engaging in their own family physician recruitment strategies, whether existing
or new.
6. The parties may share that a partnership is being explored related to the
Program as part of community engagement and public presentations.
7. Each party will be responsible for its own expenses related to this memorandum
of understanding.
8. No party will be liable to any other party for any loss that other party suffers
because of this memorandum of understanding or any failure to enter a binding
agreement with the Durham Ontario Health Team.
9. This memorandum of understanding will become effective for each party when
that party has signed it. Each party may sign this memorandum using an
electronic or handwritten signature, which are of equal effect. If the parties sign
this memorandum of understanding in several counterparts, each will be
deemed an original but all counterparts together will constitute one instrument.
10. If a party signs this memorandum of understanding but fails to date their
signature, the date the Region receives the signing party’s signature will be
deemed to be the date the signing party signed this memorandum of
understanding.
11. This memorandum of understanding will continue to apply to a party until the
earlier of (1) the date that party notifies the other parties that it no longer wishes
to proceed with the Program, (2) that party enters a binding agreement for the
Program, and (3) 31 December 2027.
Signature pages follow.
Attachment 1 to FSD-029-24
3
The Regional Municipality of Durham
Date: ________________________, 2024 By: __________________________
Nancy Taylor
Commissioner of Finance
Authorized by: #2024-COW -3
The Corporation of the Township of Ajax
Date: ________________________, 2024 By: __________________________
Name:
Title:
Authorized by:
The Corporation of the Township of Brock
Date: ________________________, 2024 By: __________________________
Name:
Title:
Authorized by:
The Corporation of the Municipality of Clarington
Date: ________________________, 2024 By: __________________________
Name:
Title:
Authorized by:
The Corporation of the City of Oshawa
Date: ________________________, 2024 By: __________________________
Name:
Title:
Authorized by:
Attachment 1 to FSD-029-24
4
The Corporation of the City of Pickering
Date: ________________________, 2024 By: __________________________
Name:
Title:
Authorized by:
The Corporation of the Township of Scugog
Date: ________________________, 2024 By: __________________________
Name:
Title:
Authorized by:
The Corporation of the Township of Uxbridge
Date: ________________________, 2024 By: __________________________
Name:
Title:
Authorized by:
The Corporation of the Town of Whitby
Date: ________________________, 2024 By: __________________________
Name:
Title:
Authorized by:
Attachment 1 to FSD-029-24
5
Attachment 1: Proposed Funding Model
Proposed Funding Model
Municipality Population1
Pop.
%
Funding
% 2H 2024 ($) 2025 ($) 2026 ($) 2027 ($)
Total Program Cost $ 55,000 $ 225,000
225,000 × (CPI +
2%)
Prior Yr × (CPI +
2%)
Durham 748,495 100% 50.0% 27,500 112,500
Ajax 135,930 18% 9.1% 4,994 20,430
Brock 13,760 2% 0.9% 506 2,068
Clarington 107,770 14% 7.2% 3,960 16,198
Oshawa 187,080 25% 12.5% 6,873 28,118
Pickering 106,505 14% 7.1% 3,913 16,008
Scugog 22,505 3% 1.5% 827 3,383
Uxbridge 22,605 3% 1.5% 831 3,398
Whitby 152,340 20% 10.2% 5,597 22,897
1 Source: #2023-INFO-102, Monitoring of Growth Trends, File: D01-02-01, as of May 2023